Black Pearl
Job description / Role
A premium dental facility is looking to hire presentable and experienced insurance coordinator for a full-time role who is fluent in English and has prior experience working in a dental clinic. In this role, you will be mainly be responsible in managing and reimbursing insurance claims for all incoming patients and will report directly to the Chief Medical Officer of the company.
Other responsibilities will include, but not limited to:
* Review, interpret, abstract clinical information from medical records for the purposes of reimbursement, research and compliance utilizing established coding principles and protocols.
* Expert in medical record review to abstract information required to support accurate outpatient and dental coding.
* Expert in assigning accurate service codes for diagnosis and procedures performed in dental setting.
* Responsible for claims submission, rejection, re-submission and all sorts of insurance documentations.
* Adhere to DOH Claims and Adjudication rules and coding guidelines.
* Obtain approval for medical/dental procedures.
* Inform patients of dental office procedures and policy.
* Move patients through appointments as scheduled.
* Enter all relevant patient information into data system.
* Maintain and manage patient records in compliance with privacy and security regulations.
* Answer and manage incoming calls.
* Complete and file insurance forms and dental billing records.
* Translate dental services into proper billable codes.
* Communicate with dental supply vendors.
* Handle test results including x-rays and dispatch lab work appropriately.
* Office duties including document filing, scanning, and creation.
* Organize referrals to other medical specialists.
* Communicate with insurance companies regarding eligibility, payments, approvals, reconciliation and other requirements.
* Explain the coverage of medical benefits to patients when required.
* Act as a resource for billing, pre-authorization, reimbursement issues and outpatient/dental.
* Ensure high level of patient data confidentiality.
* Check codes for each claim to avoid any errors to minimize rejections.
* Follow policies and procedures, completes administrative tasks accurately and on time.
