Dental Insurance Coordinator – FT

Job Responsibilities

Insurance Verification:

• Accurately creates override for all dental insurances/sliding fee scale.
• Verifies patient is on the sliding fee by checking the SFS spreadsheet on every appointment.
• Checks the balance/credit on accounts to ensure it is correct before relaying to the patient.
• Verifies and prints insurance benefits to ensure patient has dental coverage for date of service.
• Accurately calculates estimated fee’s and documents in comments section of the appointment.
• If a patient has out of network benefits ensures there is out of network coverage and accurately explains to patient what it means to be out of network for the patient.
• Understand and accurately figures out of pockets expenses when a patient has insurance and sliding fee – giving the patient the fee’s for the lesser of the two.
• Ensures all commercial insurance has remaining benefit to cover dental fee’s at every appointment.
• Checks insurance benefits to ensure treatment does not need a prior authorization.
• Sends all documentation needed for a prior authorization to the insurance company, ensures the prior authorization is approved/denied before dental appointment and follows up on any outstanding.
• Informs patient of any treatment that will not be covered and gives the patient information about the sliding fee application and process.
• Ensures all facesheets are printed for the day, attaching all paperwork that needs to be filled out and dental insurance verification to the facesheet.
• Call patients to confirm dental appointments and mark in comments and on scheduling sheet if confirmed or left message with date/time.

Job Responsibilities & Performance Criteria:

• Reviews the schedule to ensure the correct providers have been selected for the appointment and adjusts as needed.
• Checks Open Dental on all scheduled appointments to ensure they are scheduled correctly to include treatment and to make sure the recare appointment is not early.
• Reviews appointment types to ensure the correct one was selected, if not change to correct appointment type.
• Assists other clinics with insurance verification as needed.
• Any other duties as requested by Clinic Manager.