Pediatric OR Scheduler/Insurance Plan Builder

Archway Dental Partners•Danbury, CT

13h

About The Position

This role involves coordinating pediatric operating room (OR) cases, managing insurance plan building within Dentrix Ascend, and handling billing and follow-up. Additionally, it includes managing the full provider credentialing process to obtain and maintain hospital privileges. The ideal candidate will have previous dental or medical office experience, preferably in pediatrics, and strong familiarity with dental insurance plans and practice management software.

Requirements

Previous dental or medical office experience preferred (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
Strong organizational and time management skills
Excellent communication and customer service abilities
Experience with insurance verification and pre-authorizations preferred
Ability to manage multiple priorities in a fast-paced environment

Nice To Haves

Pediatric experience
Experience with Dentrix Ascend or similar dental practice management software
Experience with insurance verification and pre-authorizations

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