The insurance coordinator is accountable for establishing, achieving, and maintaining the integrity of insurance claims within the practice. Depending on the practice’s delegation of accountability between the insurance coordinator and treatment coordinator, the insurance coordinator is responsible for: (i) verifying patient’s insurance plan and associated benefits; (ii) submitting necessary insurance documentation to ensure insurance carriers make restitution promptly; (ii) overseeing practice collections; and (iii) maintaining minimum outstanding balances. The outcome is to maintain a “zero balance” office and payment of all claims within thirty days in coordination with treatment and appointment coordinators.
QUALIFICATIONS: An example of acceptable qualifications:
- High school diploma or equivalent, some college preferred
- Minimum two years’ work experience in dentistry
LICENSURE, REGISTRATION AND/OR CERTIFICATION REQUIREMENTS:
- Ohio driver’s license
EQUIPMENT OPERATED: The following are examples only and are not intended to be all inclusive.
Computer, printer/scanner/copier, facsimile machine, shredder, telephones, and other office equipment
JOB DESCRIPTION AND WORKER CHARACTERISTICS:
ESSENTIAL FUNCTIONS OF THE POSITION:
- Verifies insurance plans and associated benefits for all patients at all practice office locations at least three business days in advance of patient’s appointment; completes insurance company information request form also at least three days in advance of patient’s appointment, and scans and saves same in patient’s file once completed; updates notes in appropriate patient file in practice management software about status of verifying patient’s insurance.
- Posts patient payments received in the mail, applies insurance deductibles, and notes any errors in practice management software system with payment in note box; posts all payments received from insurance companies; handles any denials, narratives, and problems associated with insurance claims.
- Sends insurance claims through practice management software or by mail accordingly; monitors issues or concerns in the practice management software related to insurance claims and ensures that the clearinghouse system works for the practice’s claims; communicates potential coding problems, trends, and insurance issues to the appropriate support staff members or representatives; reviews and corrects claim errors, including any issues with payment from insurance to patient; updates notes in practice software accordingly, including
when patients’ insurance claims are filed, emails are sent to patient, and other status updates related to filing patient insurance claims .
- Resubmits remaining balances from primary insurance to secondary insurance; manages all EOBs and reporting for billing purposes; maintains required patient payment records, reports, and files.
- Posts, reviews, and follows-up on all correspondence from insurance companies; files appeals as necessary to receive payment from insurance companies; tracks insurance company fees and compares to usual and customary rates; researches PPO options with different insurance companies for review; acts as the official liaison between the practice and insurance companies.
- Follows-up on any insurance focus review patients; follows-up and documents denied insurance claims; researches refund requests and prepares requests for approval; handles and maintains all credits reported and issued.
- Uses the computer system to generate information necessary for billing purposes and bills all patients for outstanding bills/balances; makes sure all balances are accurate on patient accounts; calls patients with outstanding balances and reviews the balance to maintain an open line of communication and sense of trust with patients.
- Generates overdue account balance reports; generates aging reports for outstanding insurance claims and investigates all non-payments; contacts insurance companies regarding why claims are not paid.
- Demonstrates regular and predictable attendance.
- Meets all job safety requirements and all applicable OSHA safety standards that pertain to essential functions.
- Maintains required licensure, registration, and certification.
- Performs other related duties as required.
KNOWLEDGE, SKILLS, ABILITIES:
- Excellent communications skills
- Well-organized and detail-oriented
- Strong interpersonal, organizational, and anticipation skills in a team environment
- Effective verbal skills to communicate with patients, insurance companies, and other staff
- Computer skills
- Letter composition skills
- Ability to be a team player
- Ability to develop professional relationships with external vendors
- Ability to handle multiple tasks in a fast-paced environment
- Ability to work flexible hours, including some evenings
- Ability to travel between practices
Please download and complete our application for employment and submit with resume to firstname.lastname@example.org