Pediatric OR Scheduler/Insurance Plan Builder
About The Position
This role involves coordinating all aspects of pediatric operating room (OR) cases, including communication with patients/parents, scheduling pre-operative appointments, facilitating medical clearances, and ensuring all required documentation is completed. The position also requires building and maintaining insurance plans in Dentrix Ascend, setting up new insurance carriers, verifying plan accuracy, and coordinating with the billing team to resolve discrepancies. Additional responsibilities include accurate treatment entry, supporting billing and documentation for OR cases, following up on outstanding balances, and managing the full provider credentialing process to obtain and maintain hospital privileges, ensuring compliance with all office and hospital requirements.
Requirements
- Strong organizational and time management skills
- Excellent communication and customer service abilities
- Ability to manage multiple priorities in a fast-paced environment
Nice To Haves
- Previous dental or medical office experience (pediatric experience a plus)
- Experience with Dentrix Ascend or similar dental practice management software strongly preferred
- Familiarity with dental insurance plans, fee schedules, and benefit structures
- Experience with insurance verification and pre-authorizations preferred
Responsibilities
- Coordinate all aspects of pediatric operating room (OR) cases
- Communicate with patients/parents regarding procedures, expectations, and timelines
- Schedule pre-operative appointments and confirm OR dates and start times
- Facilitate medical clearances with Primary Care Physicians (PCPs)
- Ensure all required documentation (H&P, hospital forms, etc.) is completed and submitted on time
- Collaborate with providers to review medical histories and confirm appropriate case placement
- Submit and track medical insurance pre-authorizations
- Maintain accurate records and ensure all case details are complete prior to surgery
- Build and maintain insurance plans in Dentrix Ascend with accurate fee schedules, coverage tables, and plan details
- Set up new insurance carriers and update existing plans as benefit information changes
- Verify insurance plan accuracy to support clean claim submission and reduce denials
- Coordinate with the billing team to resolve plan discrepancies and ensure proper claim routing
- Review and update coverage percentages, frequencies, and limitations within Dentrix Ascend
- Maintain organized records of insurance plan documentation and benefit breakdowns
- Enter treatment accurately into the patient ledger
- Support proper billing and documentation for OR cases
- Follow up on outstanding balances after claim processing
- Manage the full provider credentialing process to obtain and maintain hospital privileges, enabling the doctor to treat patients in the hospital setting
- Complete and submit credentialing applications to hospitals and credentialing bodies on behalf of the provider
- Track credentialing timelines, expiration dates, and renewal requirements to ensure uninterrupted hospital access
- Maintain an organized credentialing file, including malpractice insurance, DEA certificate, state dental license, BLS/ACLS, and all required hospital-specific documentation
- Serve as the primary point of contact between the practice and hospital medical staff offices throughout the credentialing and re-credentialing process
- Ensure compliance with all office and hospital credentialing requirements
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
Number of Employees
11-50 employees
