Insurance Specialist Jobs

About The Position

Requirements

• High school diploma or general education degree (GED)
• 1 - 3 years’ related experience. Related education may be substituted for experience on a year for year basis.
• Knowledge of commercial dental insurance policies, services, guidelines, and procedures.
• Skilled in dental terminology.
• Skilled in written disputes of non-payment for services due to processing errors.
• Skilled in communicating insurance policies and procedures to patients and services providers.
• Ability to ensure commercial dental insurance compliance and payment of services.
• Ability to analyze insurance notification of changes in order to present plan participation recommendations to clinical financial administrator.
• Ability to address complaints, grievances and appeals.

Nice To Haves

• Knowledge commercial dental insurance policies, services, guidelines, and procedures.
• Skilled in dental terminology.
• Skilled in written disputes of non-payment for services due to DentaQuest processing errors.
• Skilled in communicating dental insurance policies and procedures to patients and services providers.
• Ability to ensure compliance with the various dental insurance providers and payment of services.
• Ability to analyze dental insurance notification of changes in order to present plan participation recommendations to clinical financial administrator.
• Ability to annotate the oral dentition.

Responsibilities

• Investigate and research information to resolve dental insurance discrepancies.
• Handle incoming calls including the processing of credit card payments over the phone.
• Coordinate with Business Manager, Account Specialists, and Program Assistants the required dental insurance paperwork and dental x-ray documentation.
• Contact the various dental insurance companies by phone to obtain missing or incomplete information so that accounts will be billed correctly.
• Update Axium with new dental insurance plans as needed.
• Verify patient dental insurance eligibility with numerous insurance companies including Medicaid.
• Update patient dental insurance and personal information as needed.
• Update third party liability through Medicaid to ensure the latest dental insurance revisions.
• Obtain pre-authorizations from insurance companies to ensure patient is eligible for treatment prescribed by doctor.
• Manage patient dental insurance plans and contracts including patient records, insurance templates, and master files.
• Rebill treatment and planned treatment to current insurance.
• Run insurance A/R report monthly.
• Coordinate with dental providers to obtain necessary information (i.e. narratives, treatment notes) in order to submit accurate claims and to resolve disputes/appeals.

Benefits

• Generous paid vacation, sick leave, and personal days
• 17 paid Federal holidays
• Thanksgiving Day and the Friday after Thanksgiving off
• Full winter break from Christmas Day through New Year’s Day
• Medical, dental, and vision insurance
• Short-term and long-term disability
• Life insurance options
• 401(k) with a competitive employer match of up to 6%