Dental Insurance Verification Specialist

Revenue Cycle Management Insurance Verification Specialist

The Revenue Cycle Management Insurance Verification (RCM IV) Specialist is responsible for utilizing the daily insurance verification report to complete insurance coverage and benefits. This role is critical to the success of each patient's visit, as the IV specialist ensures that the patient's insurance, coverage table, fee schedule, and other relevant details are accurately linked prior to the scheduled appointment. The IV specialist will also respond to same-day appointment requests. A comprehensive understanding of various insurance plans and benefits is essential for the insurance verification specialists.

This role requires exceptional accuracy and efficiency, along with a readiness to perform effectively in demanding situations.

Duties and Responsibilities

• Procure a comprehensive breakdown of benefits for each patient utilizing ZKeep or through direct phone contact if not previously acquired via the automated bot. Upload this documentation to the patient's document center.
• Responsibility for accurately associating patients with their respective insurance plans, fee schedules, creating new group plans as required, updating coverage tables, maximums, frequency limitations and deductibles within Dentrix Enterprise.
• Process all work that is assigned through the insurance verification hub and the goal is to complete no less than 75 verifications per day.
• Prompt resolution with all tickets assigned being completed within a 20 minute period. For those 'in chair' completion of the request to be completed within a 10 minute timeframe.
• 95% of all appointments verified with no errors.
• Liaise with dental offices as necessary regarding patient coverage and/or benefits.
• Maintain and update the master fee grid by integrating new plan information as it becomes available.

Requirements and Skills

• A minimum of one to two years of experience in the dental field is required.
• Proficiency in computer applications, including Microsoft Excel and Word, and the Google Suite.
• Experience with practice management software is required, with a preference for Dentrix.
• Exceptional written and verbal communication abilities.
• Proven capability to manage and prioritize multiple concurrent tasks.