Dental Insurance Specialist-Pittsburg, KS
POSITION: Dental Insurance Specialist
DEPARTMENT: Mission Control
REPORTS TO: Mission Control Manager
DIRECT REPORTS: None
FLSA STATUS: Non-Exempt
The core values of Community Health Center of Southeast Kansas, Inc. (CHC/SEK) are dignity and stewardship. Each staff member is expected to perform their job duties in a way that preserves dignity for our patients and maintains good stewardship of CHC/SEK’s resources.
This position is part of the Mission Control and provides critical support to the dental team. The Dental Insurance Specialist is responsible for providing excellent customer service by helping to ensure that dental appointments are scheduled in an efficient, accurate, and timely manner as well as understanding revenue cycle and insurance and conveying this information an understandable manner to providers, staff and patients. This position may be the first interaction that patients have with CHC/SEK and it is imperative that interactions, attitudes and practices not create barriers to care.
- Answers patient phone calls and responds to messages to schedule appointments following the Dental Scheduling Protocol and the timeliness goals established by CHC/SEK.
- Audits the schedule to ensure all scheduling parameters are met.
- Communicates effectively with patients to ensure they are educated on appointments and expectations to include the appointment confirmation policy.
- Understands and retains basic dental knowledge and procedures to ensure appointments are correct and to be able to communicate effectively with patients.
- Verifies patient demographic information with the patient and updates information into the system as needed.
- Updates and verifies financial information and insurance required for scheduling dental appointments and ensures all financial guidelines are met.
- Conducts reminder appointment phone calls, confirms appointments as needed, and works to fill any available appointment slots on the schedule.
- Interpret insurance explanation of benefits and ability to convey out of pocket expenses to the patient
- Complete prior authorizations for restorative and major procedures based on patient’s insurance plan requirements and schedule and complete prior authorizations for operating room and in-clinic sedation dentistry.
- Timely submission of prior authorizations via insurance website or telephone.
- Thorough knowledge of financial assistance program for general dentistry and SEK Smiles, CHC/SEK’s pediatric dental program.
- Ability to complete dental special services estimates, payment agreements and collection of required payment
EDUCATION AND EXPERIENCE
- High School diploma or equivalent
- Experience in clinic, healthcare setting, or call setting, preferred.
- Dental terminology, preferred.
KNOWLEDGE, SKILLS AND ABILITIES
- Social and cultural sensitivity appropriate to ethnically and economically diverse patient-and employee-base.
- Demonstrate knowledge of the rationale of appropriate patient care.
- Must be organized and able to manage/prioritize tasks to meet deadlines, adapts to change in a positive manner, able to work as a part of a team.
- Communicates through appropriate channels. Use proper chain of command for patient complaints.
- Ability to handle emergency situations calmly and effectively.
- Must be computer literate, especially with Microsoft Office products and be proficient with the Electronic Health Record software.
- Must be able to maintain good inter-personal relationship with co-workers and other members of the health care team and the organization.
- Provide customer service in accordance to the organization’s mission.
- Be courteous and respectful when interacting with patients and family members.
- Maintain patient confidentiality in accordance to organization’s policy and procedure and HIPAA requirements.
While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, peripheral vision, depth perception and ability to adjust focus. The noise level in the work environment is usually moderate.