Job Description

This role will be responsible for acting as the intermediary between patients and various insurance company for the dental services offered by the facility. This role will also be responsible for verifying patient health insurance benefits, communicating with patients, and processing insurance payments.

A. Administration

• Document and update all services rendered to patient's file
• Provide updated list of approved patients via Dok32 to reception and dentist to call and schedule appointments
• Accurate communication to patients and dentist departments in regards to queries for insurance policy, coverage and limit
• Create monthly reports for the Medical Director and Dental department such as: no. of approved cases, upcoming appointments, remaining appointments, and total cases rendered
• Fill reimbursement forms if required for uncovered insurance policies holders

B. Medical Insurance

• Ensure proper documentation of patient's file for any dental procedure that requires prior-approval request
• Use implemented system to claim pre-approved cases upon completion of planning from treating dentist on a daily basis.
• Follow the designated procedures to ensure approval of claims and prevent denied claims
• Coordinate and inform treating dentist for any incorrect clinical note such as the diagnose, procedure code, tooth number and time of treatment.
• Update the reception and dental department for approved claims in order to schedule appointments
• Coordinate with cashier to ensure accurate and updated insurance card details before the patients meets the treating dentist
• In cases for denied claims, conduct follow-ups with insurance companies and inquire for justification on denied claims
• Re-submit denied claims upon reviewing denial code received from insurance companies
• In cases of re-denied claims, consult with the treating dentist and the Chief Medical Officer for appropriate action
• Update patient file for final denied claims and inform the treating dentist and patient accordingly
• Bill daily rendered procedures and prepare submission to covered insurance companies and self-paid patients
• Adhere to task given by the Chief Medical officer

Qualifications:

• With at least 2 years of experience as an Insurance Coordinator in Dental field
• Ability to work in a pressurized work environment
• Knowledge in using Dental EMR is a plus

Job Type: Full-time

Experience:

• DENTAL: 1 year (Required)