Dental Claims Coordinator- Special Needs Clinic

Responsibilities: Prepares and submits insurance claims and pre-authorizations (electronic and paper); monitors all unsubmitted or denied claims. Identifies and resolves payment issues proactively, coordinating with payers to obtain claim approvals. Audits patient records for accurate financial and CDT coding documentation; initiates corrections and communicates with providers to ensure compliant submissions. Collaborates with the hospital to create a streamlined process (create and monitor PAs, insurance coordination, and hospital coordination).Assists students, residents, and staff in understanding insurance protocols. Maintains up-to-date knowledge of CDT coding, Medicaid/Medicare rules, and payer regulations for dentistry. Explains treatment costs and insurance coverage. Performs other duties as assigned. QualificationsEDUCATION:High School Diploma or GED. (TRANSCRIPT REQUIRED)

EXPERIENCE: Four (4) years of public and private dental claims processing; OR Associate's Degree and two (2) years of public and private dental claims processing. KNOWLEDGE, SKILLS, AND ABILITIES:Ability to organize and prioritize work to meet competing deadlines. Knowledge of special needs patient population guidelines, regulations, policy, and procedures Knowledge of public and private dental insurance billing policies. Ability to manage multiple job priorities and tasks efficiently, effectively, and accurately while demonstrating close attention to detail. Expert knowledge of dental terminology, treatment planning, CDT coding, accounts receivable and collections processes. Ability to communicate professionally and courteously with faculty, residents, students, patients and staff. Ability to identify, research and/or resolve financial conflicts with insurance companies and patient accounts.