UNIV - Treatment Care Coordinator - College of Dental Medicine

UNIV - Treatment Care Coordinator - College of Dental Medicine

The Treatment Care Coordinator (TCC) supports patients through consultation, treatment acceptance, insurance prior authorization, financial clearance for the College of Dental Medicine (CDM). Reporting to the Senior Manager of Care Coordination & Access Services, this role works closely with providers, Patient Service Representatives (PSRs), and the Billing Office to ensure patients clearly understand their treatment plan, insurance benefits, and available payment options. This position plays a critical role in keeping the OR schedule full, promoting case acceptance by ensuring patients have a clear understanding of treatment recommendations and financial commitments. The Treatment Care Coordinator will follow up with patients who do not commit to treatment at the consultation visit to answer questions and support treatment decisions. This position also addresses patient concerns and questions about finances and any balances they may become past due.

Entity: Medical University of South Carolina (MUSC - Univ)

Worker Type: Employee

Worker Sub-Type: Classified

Cost Center: CC001135 CDM Dental Teaching Clinic

Pay Rate Type: Hourly

Pay Grade: University-GEN07

Pay Range: 39,300.00 - 53,100.00 - 66,800.000

Scheduled Weekly Hours: 40

Work Shift:

Job Responsibilities

30%:

• Review upcoming consultation appointments to ensure insurance information and patient records are accurate and complete.
• Verify insurance benefits, submit prior authorizations when needed and prepare treatment cost estimates prior to the consultation appointment.
• Coordinate with the Billing Office when clarification of insurance benefits or coverage is required.
• Ensure financial estimates are prepared in advance so providers and patients can review treatment costs during consultation visits.
• Document insurance verification and financial estimates accurately in the Electronic Health Record (EHR).
• Manage case coordination activities, including preparation, submission, and tracking of required documentation and authorization paperwork in accordance within compliance guidelines. Work closely with the Billing Office to ensure all necessary forms, approvals, and supporting documentation are completed accurately and maintained within the patient record to support treatment authorization and compliance requirements.

25%:

• Enter referrals in EHR. Ensure images and all referral information is added to the EHR.
• Register patients, verify insurance benefits, and prepare treatment cost estimates.
• Contact patients to schedule consultation appointments.
• Ensure insurance information and patient records are accurate and complete.
• Coordinate with the Billing Office when clarification of insurance benefits or coverage is required.

25%:

• Meet with patients during or immediately following their consultation appointment to review recommended treatment plans.
• Submit insurance prior authorizations for OR cases as needed.
• Explain treatment costs, insurance coverage, patient financial responsibility, and available payment options.
• Educate patients on CDM financial policies.
• Ensure patients clearly understand treatment expectations, timeline, and financial commitment prior to initiating treatment.
• Document insurance verification and financial estimates accurately in the Electronic Health Record (EHR).
• Accurately document treatment acceptance or financial discussions within the EHR.
• Support case acceptance by addressing patient questions related to treatment plans, insurance coverage, and payment options.

10%:

• Serve as a communication liaison between providers, PSRs, and the Billing Office regarding treatment plans, insurance coverage, and financial arrangements.
• Coordinate with front desk staff to ensure patients are scheduled appropriately for treatment start appointments.
• Work with providers to clarify treatment recommendations when patients have additional questions regarding their treatment plan.
• Facilitate resolution of patient questions related to financial estimates, insurance benefits, or payment arrangements and past due balances.
• Assists front desk areas with PSR duties as needed.

10%:

• Ensure all financial discussions, insurance verification, and treatment acceptance documentation are recorded accurately in the EHR.
• Maintain compliance with HIPAA privacy regulations and CDM financial policies.
• Participate in departmental meetings, training, and quality improvement initiatives related to patient access and care coordination.
• Support operational improvements aimed at enhancing case acceptance and patient experience.
• All other duties as assigned by manager.

Additional Job Description

Minimum Requirements: A high school diploma and four years relevant experience in business management, public administration or administrative services; or a bachelor's degree and two years experience in business management, public administration or administrative services.

Physical Requirements: (Note: The following descriptions are applicable to this section: Continuous - 6-8 hours per shift; Frequent - 2-6 hours per shift; Infrequent - 0-2 hours per shift) Ability to perform job functions in an upright position. (Frequent) Ability to perform job functions in a seated position. (Frequent) Ability to perform job functions while walking/mobile. (Frequent) Ability to work indoors. (Continuous) Ability to work outdoors in all weather and temperature extremes. (Infrequent) Ability to work in confined/cramped spaces. (Infrequent) Ability to perform job functions while kneeling positions. (Infrequent) Ability to bend at the waist. (Frequent) Ability to squat and perform job functions. (Infrequent) Ability to perform 'pinching' operations. (Infrequent) Ability to fully use both hands/arms. (Continuous) Ability to perform repetitive motions with hands/wrists/elbows and shoulders. (Frequent) Ability to reach in all directions. (Frequent) Possess good finger dexterity. (Continuous) Ability to maintain tactile sensory functions. (Continuous) Ability to lift and carry 15 lbs., unassisted. (Infrequent) Ability to lift objects, up to 15 lbs., from floor level to height of 36 inches, unassisted. (Infrequent) Ability to lower objects, up to 15 lbs., from height of 36 inches to floor level, unassisted. (Infrequent) Ability to push/pull objects, up to 15 lbs., unassisted. (Infrequent) Ability to maintain 20/40 vision, corrected, in one eye or with both eyes. (Continuous) Ability to see and recognize objects close at hand. (Continuous) Ability to see and recognize objects at a distance. (Frequent) Ability to match or discriminate between colors. (Frequent) Ability to determine distance/relationship between objects; depth perception. (Continuous) Good peripheral vision capabilities. (Continuous) Ability to maintain hearing acuity, with correction. (Continuous) Ability to hear and/or understand whispered conversations at a distance of 3 feet. Ability to perform gross motor functions with frequent fine motor movements. (Frequent) Ability to work in dusty areas. (Infrequent)

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees.