Dental Insurance Coordinator

A Dental Insurance Coordinator is a vital member of a dental practice's administrative team, acting as the primary liaison between the dental office, patients, and insurance companies. Their main goal is to maximize insurance reimbursements and ensure accurate financial information for patients.

Key Responsibilities

• Insurance Verification & Eligibility:
• Verify patient insurance benefits accurately and efficiently by contacting insurance providers, using online portals, or through other communication channels.
• Determine patient eligibility for dental services and understand coverage details, limitations, and deductibles.
• Obtain pre-authorizations or pre-determinations for specific treatments as required by insurance plans.
• Claims Processing & Submission:
• Prepare, submit, and track dental insurance claims accurately and in a timely manner.
• Ensure all necessary documentation (X-rays, narratives, charting) is included with claims.
• Follow up on outstanding claims with insurance companies to ensure prompt payment.
• Resubmit denied or rejected claims with corrected information.
• Patient Financial Communication:
• Explain insurance benefits, coverage, and potential out-of-pocket costs to patients clearly and concisely.
• Provide accurate treatment plan estimates to patients, outlining insurance coverage and patient responsibility.
• Assist patients with understanding their dental benefits and how they apply to their treatment.
• Billing & Payments:
• Post insurance payments and adjustments accurately into the practice management software.
• Manage patient accounts receivable, including billing patients for their portion of costs.
• Follow up on overdue patient balances and assist with payment arrangements.
• Process refunds when necessary.
• Record Keeping & Administration:
• Maintain accurate and up-to-date patient insurance information in the practice management system.
• Keep detailed records of all insurance communications, claims, and payments.
• Generate reports related to insurance claims, payments, and accounts receivable.
• Stay informed about changes in insurance policies, procedures, and billing codes.
• Collaboration:
• Work closely with dentists, hygienists, and other dental staff to ensure smooth patient flow and accurate treatment coding.
• Communicate effectively with insurance company representatives to resolve issues and discrepancies.

Qualifications and Skills

• Education:
• High school diploma or GED is typically required.
• A certificate or associate's degree in healthcare administration or a related field may be preferred.
• Experience:
• Previous experience in a dental office setting is highly desirable.
• Experience with dental insurance verification, claims processing, and billing is essential.
• Familiarity with dental practice management software (DOK32) is often required.
• Skills:
• Excellent communication skills (verbal and written) to effectively interact with patients and insurance providers.
• Strong attention to detail and accuracy is crucial for data entry and claims processing.
• Proficiency in data entry and computer skills, including Microsoft Office Suite.
• Knowledge of dental terminology, procedures, and common insurance billing codes (e.g., CDT codes).
• Understanding of various dental insurance plans (PPOs, HMOs, FFS) and how they work.
• Organizational and time management skills to handle multiple tasks and prioritize effectively.
• Problem-solving abilities to resolve claim denials and billing issues.
• Customer service orientation to assist patients with financial concerns.
• Ability to work independently and as part of a team.

A skilled Dental Insurance Coordinator is instrumental in ensuring the financial health of a dental practice while providing patients with clear and transparent information about their treatment costs.

Job Type: Full-time