Pediatric OR Scheduler/Insurance Plan Builder

Description Key Responsibilities Pediatric OR Scheduling Coordinate all aspects of pediatric operating room (OR) cases Communicate with patients/parents regarding procedures, expectations, and timelines Schedule pre-operative appointments and confirm OR dates and start times Facilitate medical clearances with Primary Care Physicians (PCPs) Ensure all required documentation (H&P, hospital forms, etc.) is completed and submitted on time Collaborate with providers to review medical histories and confirm appropriate case placement Submit and track medical insurance pre-authorizations Maintain accurate records and ensure all case details are complete prior to surgery Insurance Plan Building — Dentrix Ascend Build and maintain insurance plans in Dentrix Ascend with accurate fee schedules, coverage tables, and plan details Set up new insurance carriers and update existing plans as benefit information changes Verify insurance plan accuracy to support clean claim submission and reduce denials Coordinate with the billing team to resolve plan discrepancies and ensure proper claim routing Review and update coverage percentages, frequencies, and limitations within Dentrix Ascend Maintain organized records of insurance plan documentation and benefit breakdowns Billing & Follow-Up Enter treatment accurately into the patient ledger Support proper billing and documentation for OR cases Follow up on outstanding balances after claim processing Additional Responsibilities Manage the full provider credentialing process to obtain and maintain hospital privileges, enabling the doctor to treat patients in the hospital setting Complete and submit credentialing applications to hospitals and credentialing bodies on behalf of the provider Track credentialing timelines, expiration dates, and renewal requirements to ensure uninterrupted hospital access Maintain an organized credentialing file, including malpractice insurance, DEA certificate, state dental license, BLS/ACLS, and all required hospital-specific documentation Serve as the primary point of contact between the practice and hospital medical staff offices throughout the credentialing and re-credentialing process Ensure compliance with all office and hospital credentialing requirements Requirements Qualifications Previous dental or medical office experience preferred (pediatric experience a plus) Experience with Dentrix Ascend or similar dental practice management software strongly preferred Familiarity with dental insurance plans, fee schedules, and benefit structures Strong organizational and time management skills Excellent communication and customer service abilities Experience with insurance verification and pre-authorizations preferred Ability to manage multiple priorities in a fast-paced environment #J-18808-Ljbffr Norwalkdentalassociates