What are the responsibilities and job description for the DENTAL SERVICES MANAGER position at Whitman-Walker Health?

Job Description

Job Summary

The Clinical Infrastructure Department is our centralized medical, dental, and behavioral health support department. The Dental and Administrative Services Manager supervises the Dental Services Representatives. This position includes responsibility for front and back administrative dental office functions at our NW and SE locations, training staff, scheduling, registration, entering demographic and registration data in the eClinical Works electronic medical record, insurance verification, pre-authorization, claim data, reviewing and updating appointments, collecting and posting payments, customer service, troubleshooting errors, responding to patient requests, explaining health center policies; generating statistical reports; preparing Dental Services Representatives (DSR) staff schedules, approving leave requests and time sheets; monitoring staff performance and providing feedback. This position is empowered to address and resolve customer concerns or complaints. Implements section 1557 of the Affordable Care Act (ACA) concerning the availability of qualified interpreters as outlined in the Whitman-Walker Language Access Policy.

Role Specific Primary Essential Duties :

The Manager directs and oversees the day-to-day operations and activities of dental service representatives, provides mentoring and technical assistance on issues that arise, and monitors the timeliness and quality of all services provided.
Manages the day-to-day operations related to staff scheduling, staff admin time, individual supervision, team meetings, departmental policies and procedures, training needs, and prompt and efficient delivery of high-quality services.
Hire, onboard, and train DSR staff to include customer service training, de-escalation training, departmental and health center policy, and procedure, current EMR and dental software, registration, scheduling, claim data, payment collection and posting, benchmarks, Whitman-Walker services, community resources, language access, prior authorization, and insurance verification.
Develop departmental policy and procedures and training documents, to include specific, time-framed, and measurable goals and objectives.
Ensures commercial insurance and DC Alliance patients do not exceed the annual maximum.
Manage outgoing referrals to specialists for treatment needs.
Obtain internal referrals and schedule new patients for appointments.
Maintains all passwords for the Managed Care / third-party dental carriers who allow claims status via provider websites.
Verify patient / client dental insurance benefits and obtain pre-authorizations as required by the dental plan.
Review the Dental schedule a month ahead to verify that all procedures scheduled that need pre-authorization have been approved. Notify providers assigned DSR to follow up with the provider and submit and obtain pre-authorization.
Maintain all Medicaid benefit Grids up to date in SharePoint and / or eCW for DSR’s and doctors to know what is covered by Medicaid MCO’s and to give guidance to what is needed to be attached to preauthorization for them to be approved.
Maintain Commercial Insurances fee schedules and SFS fee schedules up to date in SharePoint and / or eCW for DSR’s to provide patients with the most up-to-date estimate of cost for dental procedures.
Collaborate with Dental staff to resubmit patient pre-authorization denials.
Confirm that the balance of patients with commercial insurance is accurate along with DSR. Notify third-party billing if an adjustment is needed. Upload EOB to dental software program to present to patient at the time of check-in.
Review treatment plan, dental benefits, pre-authorization decision, and pre-estimate payment obligations with patient / client and address any concerns.
Assure patient charges, payments, and credits are posted.
Administer process of patients / clients’ dental follow-up appointments.
Review, respond, and address patient feedback and complaints, including prompt follow-up with staff and ensure any issue is resolved.
Review, respond, and address patient feedback and complaints, and Compliance initiated incident reports, including prompt follow-up with staff and ensure any issue is resolved. Coach DSR staff through challenging customer service issues.
Assures the dental reception and office assistant reception desks are staffed at the designated times.
Prepare monthly reports for upper management and make recommendations for Process Improvement to address any deficiencies.
Provide feedback to staff addressing performance and metrics.
Record staff time. Approve time-off requests. Approve payroll time and attendance.
Track employee absences and tardiness and hold employees accountable to WWH attendance policy by providing ongoing feedback and disciplinary action when appropriate.
Monitor staff compliance with departmental policies, procedures, training, directives, HIPAA, and health center employee handbook policy and procedures. Hold monthly meetings with staff to review performance.
Initiate corrective and disciplinary action in conjunction with the Sr. Manager of Clinical Infrastructure.
Assure that pertinent information is effectively communicated to DSR staff regarding changes related to provider schedules, telephone messages, access, and clinic updates.
Processes incoming mail in the 6th-floor dental inbox.
Manages E-messages in different platforms and EMR.
Provides coverage when needed.

Management Responsibilities

Supervises, schedules, monitor performance, provides feedback, and initiates corrective action to / with Dental Service Representatives.

Role Specific- Knowledge, Skills, and Talents Required :

Knowledge of standard dental office operations including patient scheduling, dental terminology, dental insurance verification, dental prior authorization, dental billing, and dental software.

Knowledge of health center front and back-office operations and ability to understand and become knowledgeable of PCMH, Ryan White and other grant requirements, and FQHC requirements as they relate to patient scheduling, registration, insurance verification, prior authorization, billing, payment collection, and payment posting.

Knowledge of principles and processes for providing excellent customer service in telephone, face-to-face interpersonal, and written correspondence - including the ability to assess customer needs, meet quality service standards, evaluate customer satisfaction, coach staff, and effectively de-escalate difficult customer encounters.

Ability to effectively use computer software and technology as required by WWH, including Microsoft Office products, eCW, eCW dental, and Open Dental.

Ability to : work professionally, communicate in an effective and professional manner, work independently and in a team environment, multi-task, manage time effectively to achieve goals and objectives, work well under pressure, adapt to a changing environment, and reprioritize as necessary, adhere to a budget, and utilize analytical skills for the preparation of accurate, concise, and comprehensive reports.

Ability to interact with patients and staff with kindness, in a friendly, sensitive, empathetic manner that respects dignity and diversity, including factors such as HIV status, race, ethnicity, ability, age, sexual orientation, and gender identity.

Ability to understand and become knowledgeable of programs and services (including knowledge of HIV-related illnesses, current treatment, and adherence / risk reduction / intervention strategies) provided by WWH, WWH policies and procedures, and Federal, state, and local laws relating to the services provided at WWH, and the Collective Bargaining Agreement for supervising employees in Union positions.

Flexibility to work alternative hours and shifts, and locations, as necessary, to ensure adequate coverage.

Promote and maintain positive inter and intra-department relations and work harmoniously with others.

Education and Experience Required

Bachelor’s degree or equivalent work experience required.

3 years of experience in dental practice including verifying dental insurance and benefits, obtaining prior authorizations, scheduling patients, collecting, and posting payments, and providing dental reception desk coverage required.

Fluency in Dental Terminology is required.

2 years of experience working with a broadly diverse population and the ability to work harmoniously with diverse groups of individuals are required.

2 years of experience working with people living with HIV or issues related to HIV care preferred.

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