Dental Insurance Specialist

Insurance Verification Specialist

Perform all insurance verifications and pre-determinations/pre-authorizations. Understands and assists patients with third party billing systems. Reviews patient's insurance breakdowns for accuracy. Understands and utilizes CDT codes. Works closely with administrative and clinical staff. Build positive relationships with patients by efficiently, effectively, and courteously communicating information.

Essential Functions

To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.

• Operate office equipment, such as voice mail messaging systems, and use word processing, label making software, copier, printer and scanner.

• Communicates effectively, courteously, and professionally with patients, parents/legal guardians, and clinical and administrative staff.

• Informs patient of their fiscal responsibilities with respect to their particular insurance coverage.

• Interview patients to complete documents such as insurance forms.

• Complete insurance verification forms. Contact patient regarding pre-authorization/pre-determination status.

• Understands and utilizes CDT codes.

• Position may be responsible for opening the office.

• Treats patients, visitors and co-workers with respect and courtesy.

• Proficiently uses conflict resolution and problem-solving techniques in managing interpersonal conflict and patient complaints.

• Efficiently operates assigned computer software (i.e., Eaglesoft, and Microsoft Office Suite).

• Prepares and delivers reports on time. Ensures printed material and forms are up to date. Insurance verification forms are updated semi-annually.

• Create and follow up with Medicaid pre-authorizations and traditional insurance pre-determinations. Contact patient for additional insurance information and/or additional documentation.

• Communicate patient concerns to Dental Office Manager or Doctor.

• Complies with: Dental Depot policies and procedures; OSHA policies, procedures, rules, and regulations, as well as HIPAA policies.

• Schedule approved treatment.

• Position may be required to relocate to other Dental Depot clinics either permanently or on a short-term basis due to office needs, on an as needed basis at the discretion of Management.

• This position may complete other Administrative and Maintenance tasks as assigned by Management.

• Maintain regular and reliable attendance