Clinical Insurance Specialist in the Pre-Doc GP5 Clinics Position Control Number CIS-22-305-01

U.M. FDSP Associates is a non-profit affiliate of the University of MarylandSchool of Dentistry. U.M. FDSP Associates is the organization thatprovides patient care focused staffing for the clinic operations sothat faculty and students may provide patient care to the generalpublic U.M. FDSP Associates is a non-profit affiliate of the University of MarylandSchool of Dentistry. U.M. FDSP Associates is the organization thatprovides patient care focused staffing for the clinic operations sothat faculty and students may provide patient care to the generalpublic. We offer a comprehensive benefits package to support work-life balanceand employee well-being. Our benefits include: Time Off : Generous paid vacation,sick leave, and personal days, plus 17 paid Federal holidays. EnjoyThanksgiving Day and the Friday after Thanksgiving off, as well as a fullwinter break from Christmas Day through New Year’s Day. Health Coverage : Medical, dental, and vision insurance, along with short-term and long-termdisability, and life insurance options. Retirement : 401(k) with a competitiveemployer match of up to 6%. Work Schedule : Normaloperations hours are Monday through Friday. We prioritize flexibility, health, and financial security, creating anenvironment where employees can thrive both professionally and personally. Under general supervision accurately and professionally clarifiesand supports the administrative requirements of the various commercial patient dentalinsurance plans. Additionally, is accountable for a range of operational andadministrative duties. ESSENTIAL DUTIES AND RESPONSIBILITIES: Investigateand research information to resolve dental insurance discrepancies. Handleincoming calls including the processing of credit card payments over thephone. Coordinatewith Business Manager, Account Specialists, and Program Assistants therequired dental insurance paperwork and dental x-ray documentation. Contactthe various dental insurance companies by phone to obtain missing orincomplete information so that accounts will be billed correctly. UpdateAxium with new dental insurance plans as needed. Verifypatient dental insurance eligibility with numerous insurance companiesincluding Medicaid. Updatepatient dental insurance and personal information as needed. Updatethird party liability through Medicaid to ensure the latest dental insurancerevisions. Obtainpre-authorizations from insurance companies to ensure patient is eligiblefor treatment prescribed by doctor. Managepatient dental insurance plans and contracts including patient records,insurance templates, and master files. Rebill treatment and planned treatment tocurrent insurance. Run insuranceA/R report monthly. Coordinatewith dental providers to obtain necessary information (i.e. narratives,treatment notes) in order to submit accurate claims and to resolvedisputes/appeals. Note: The intent of this list of primary duties is toprovide a representative summary of the major duties and responsibilities ofthis job. Incumbents perform otherrelated duties assigned. Specific dutiesand responsibilities may vary based upon departmental needs. EDUCATION and/or EXPERIENCE: High school diploma or general education degree (GED); 1 - 3years’ related experience. Relatededucation may be substituted for experience on a year for year basis. Required Knowledge / Skills / Abilities: Knowledge of commercial dental insurance policies, services,guidelines, and procedures. Skilled in dental terminology. Skilled in written disputes of non-paymentfor services due to processing errors. Skilled in communicating insurancepolicies and procedures to patients and services providers. Ability to ensure commercial dental insurance compliance andpayment of services. Ability to analyze insurance notification of changes inorder to present plan participation recommendations to clinical financial administrator.Ability to address complaints, grievances and appeals. pERFERRED Knowledge / Skills / Abilities: Knowledge commercial dental insurance policies, services,guidelines, and procedures. Skilled in dental terminology. Skilled in written disputes of non-paymentfor services due to DentaQuest processing errors. Skilled in communicating dentalinsurance policies and procedures to patients and services providers. Ability to ensure compliance with the various dentalinsurance providers and payment of services. Ability to analyze dentalinsurance notification of changes in order to present plan participationrecommendations to clinical financial administrator. Ability to annotate theoral dentition. ADDITIONAL CONDITIONS OF EMPLOYMENT: This job description is designed to give an outline ofwhat job duties are expected of this position.As an outline it does not fully describe or limit the extent of theposition’s duties. The Corporation andits supervisors may amend the job description as it deems necessary, withoutadvance notice. The job description isnot intended to create an employment contract and should not be construed assuch. #J-18808-Ljbffr U M FDSP Associates PA