Insurance Verification Specialist

My Community Dental Centers Inc.•Resort Township, MI

3d•Remote

About The Position

As a valued member of our Insurance team, the Insurance Verification Specialist plays an integral role in creating lasting impressions that promote a positive patient experience. The Insurance Verification Specialist role is essential in building a patient-centric culture that fosters loyalty and trust within the communities we serve. One of the core duties is to ensure comprehensive insurance eligibility and benefit verification, minimizing center tasking in preparation for appointments. As an organization, we believe in our mission and expect all team members to model MCDC’s culture, values, and best practices through “Exemplifying Excellence.” This position is full time with the majority of work being remote/work from home (WFH) with all computer and office equipment provided by MCDC. Reliable high-speed internet is required, must be provided by the employee, and will need to be tested by MCDC IT to verify functionality. Occasional working time may be required in an MCDC office for training, meetings, etc. Authentication into certain accounts required to perform this job may require the use of your personal mobile device for two-factor authentication purposes (whether via an authenticator app or SMS message) to authenticate your individual login to those systems. The Insurance Verification Specialist is responsible for verification of patient insurance eligibility and benefits verification in the practice management software to support billing of claims and collection of patient portion. This includes verification of patient eligibility and benefits through a staged process prior to patient appointments. The tasks will be performed using online websites or by calling insurance companies to obtain the required information, entering it in the practice management software and communicating back to the MCDC Billing team, Patient Experience team or center staff as appropriate. The person in this role must exercise independent judgment and discretion in completing all tasks assigned. The Insurance Verification Specialist works closely with insurance payers with whom we are contracted and not contracted with. The Insurance Verification Specialist interfaces closely with other Billing Department staff to ensure insurances are not negatively affecting receipt of payment for services. In addition, the person in this role must treat all information and data within the scope of this position with complete confidentiality and security including, but not limited to, following HIPPA guidelines.

Requirements

High school graduate or equivalent
Experience in healthcare insurance or dental experience helpful
Possess above average knowledge/experience with computers and software (Microsoft Windows, Word, Excel, Outlook, Teams, Open Dental, ZUUB and Internet)
Excellent typing skills
Excellent attention to detail as well as ability to review own work for quality control and correction
Ability to follow complex established processes to ensure consistency of task performance across the team
Be able to work efficiently with interruptions and manage multiple priorities at the same time
Be able to work unsupervised and exercise critical thinking skills to meet deadlines and problem-solve
Proactive approach to teamwork to ensure support of own team as well as other departments
Excellent verbal and written communication skills
Ability to maintain professional demeanor at all times demonstrating patience, adaptability and compassion
Familiarity with business machines as needed (computer, fax, copier, scanner, etc.)
Ability to read and interpret dental insurance policies and benefits descriptions
Experience with insurance to understand insurance terminology including deductibles, copays, coinsurance, covered versus noncovered, network affiliation, leased network affiliation and waiting periods

Nice To Haves

Have exceptional communication skills, and a friendly personality
Thrive on providing outstanding service and care
Are mission-driven and are eager to care for underserved communities
Can work with interruptions and effectively manage multiple priorities

Responsibilities

Access insurance payer websites, maintaining passwords and confidentiality
Investigate insurance benefits, coverage, maximum benefits and deductibles
Build new insurances into Open Dental following the Insurance Plan Process
Create new coverage tables and update existing insurance coverage tables
Monitor insurance lists to identify and remove duplicate insurances
Create/maintain process documentation for all payers to assist with training of future Insurance Specialists
Coordinate with outside vendors, if any, who are performing the same or similar tasks of creating and/or updating insurances to ensure consistency
Manage the Insurance Tasks in Open Dental
Verify patient eligibility
Communicate effectively with the Billing Department, Patient Experience team and Operations staff in a timely manner
Maintain proficiency in data entry
Provide support to Credentialing staff as it relates to insurance payers and their websites
Provide assistance to MCDC staff with understanding complex insurance situations
Secondary tasking to support the Insurance Plan Maintenance Specialists with limited backup for insurance plan creation and maintenance
Additional tasking to support the needs of the Billing Department related to insurance
Other duties as assigned