Dental Insurance Coordinator

Overview

The Insurance Coordinator is responsible for the ongoing documentation requirements of new and existing patients’ insurance benefits verification to ensure accurate treatment estimates.

Responsibilities

Core duties and responsibilities include the following. Other duties may be assigned.

• Liaise with insurance providers to elucidate patients' coverage and to resolve disputes about rejected claims
• Prioritizes and processes incoming Insurance Verifications, Referrals, and Prior Authorization requests
• Verifies member/patient eligibility
• Ensures insurance carrier documentation requirements are met
• Understands and can explain dental and medical insurance plan benefits.
• Effectively communicate with others, including physician offices, insurance companies, patients, and others about insurance benefits and costs associated to procedures.
• Handles multiple assignments or pieces of work at one time. The capability of working within a stressful environment under consistent deadlines, pressures and interruptions.
  
  

Qualifications

To perform this job successfully an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

Education

High school diploma or equivalent

Experience

Knowledge of dental/medical benefits and breakdowns a plus

Proficient computer skills

Competencies

To perform the job satisfactorily, an individual should demonstrate the following competencies:

• Technical Skills - Assesses own strength and weaknesses; pursues training development opportunities; strives to continuously build knowledge and skills; shares expertise with others
• Customer Service - Manages difficult or emotional customer situations; responds promptly to customer needs; solicits customer feedback to improve service; responds to requests for service and assistance; meets commitments
• Interpersonal Skills - Maintains confidentiality; listens to others without interrupting; keeps emotions under control; remains open to others’ ideas and tries new things
• Oral Communications - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions
• Written Communication - Writes clearly and informatively; able to read and interpret written information
• Quality Management - Looks for ways to improve and promote quality; demonstrates accuracy and thoroughness
• Diversity - Shows respect and sensitivity for cultural differences; promotes a harassment-free environment
• Ethics - Treats people with respect; keeps commitments; inspires the trust of others; works with integrity and ethically; upholds organizational values
• Organizational Support - Follows policies and procedures; completes administrative tasks correctly and on time; supports organization’s goals and values; respects diversity
• Planning/Organizing - Prioritizes and plans work activities; uses time efficiently
• Professionalism - Approaches others in a tactful manner; reacts well under pressure; treats others with respect and consideration regardless of their status or position; accepts responsibility for own actions; follows through on commitments
• Quality - Demonstrates accuracy and thoroughness; monitors own work to ensure quality
• Safety and Security - Observes safety and security procedures; reports potentially unsafe conditions; uses equipment and materials properly
• Adaptability - Adapts to changes in the work environment; manages competing demands; changes approach or method to best fit the situation; able to deal with frequent change, delays, or unexpected events
• Attendance/Punctuality - Is consistently at work on time; ensures work responsibilities are covered when absent; arrives at meetings and appointments on time
• Dependability - Follows instructions, responds to management direction; takes responsibility for own actions; keeps commitments; commits to long hours of work when necessary to reach goals; completes tasks on time or notifies appropriate person with an alternate plan
  
  

Keywords: Billing, Claims, Insurance billing, insurance claims, insurance verification