Dental Eligibility Specialist

Job Description

Job Description

COMMUNITY HEALTH:

Community Health is a primary care network that provides nationally-recognized programs, a focus on wellness, dental, behavioral health and pediatric specialties, walk-in Express Care, a culture of community and quality health care that almost everyone, insured or uninsured, has come to depend on. As an equal opportunity employer, we offer a team-oriented, collaborative work environment for close to 400 employees at eight different locations in Rutland and southern Addison counties. 

POSITION SUMMARY:

The dental eligibility specialist manages patient dental insurance benefits by verifying coverage, determining costs, coordinating prior authorizations, acting as a liaison between patients, dentists, and insurance companies to maintain patient accounts. Key duties include data entry into practice management software, providing patients with detailed information about their coverage, treatment costs, out of pocket costs, and payment options. 

ESSENTIAL FUNCTIONS:

Essential functions are those tasks, duties and responsibilities that comprise the means of accomplishing the job’s purpose and objectives.  Essential functions are critical or fundamental to the performance of the job.   They are the major functions for which the person in the job is held accountable.  The following are the essential functions of the job.

• Verify dental insurance benefits and patients out of pocket costs.
• Submit and follow up on insurance pre-authorizations.
• Review treatment plans and financial options with patients to include sliding fee if applicable.
• Complete data entry on patients’ insurance verification forms
• Verify patients’ eligibility and dental benefit information by using in-office history, calling insurance companies, looking up benefits online, and receiving benefits via fax
• Upload completed insurance verification forms and procedure history into patients’ electronic files
• Update each patient’s account with current coverage information
• Identify and communicate any insurance concerns with the appropriate departments
• Reconciles daily batch
• Maintains patient confidentiality
• Scans reports and other paperwork into charts
• Warmly greet and check in patients.
• Verify demographics and insurance information at each visit
• Answer phones, schedule appointments, and coordinate patient flow.
• Collects payments and posts accurately to patients ledger
• Maintain a clean, organized, and professional front desk area.
• Work closely with dentists and clinical staff to ensure exceptional patient care.

OTHER DUTIES:

• Other duties as assigned.

SKILLS REQUIRED FOR SUCCESS:

• High School Diploma or equivalent.
• Prior office experience preferably in a medical setting
• Basic knowledge of computer skills
• Basic medical terminology preferred
• Strong customer service skills
• Must be able to provide information regarding office policy and procedure
• Must be able to manage emergency situations in a calm manner
• Must have strong decision-making skills
• Must be able to interpret instructions and prepare records
• Maintains patient confidentiality
• Previous experience in a dental office is a plus
• Knowledge of dental procedures, terminology, and insurance billing codes is a plus
• Clear communication skills, both written and verbal
• Excellent time management and organizational skills
• Strong attention-to-detail

HOW WE SUPPORT YOU:

• Work Life Balance
• Generous Time Off
• Medical, dental, and vision insurance.
• Health savings account option.
• Robust 403 (b) retirement savings plan, with employer match and 100% vesting schedule.
• Comprehensive Wellness Program.