Insurance Coordinator

Position Summary: 

We are seeking a detail-oriented and proactive Insurance Coordinator to join our dental team. This role is essential in ensuring accurate insurance verification, claim submission, and reimbursement for services rendered. The ideal candidate will have experience working with both state-funded programs (e.g., Medicaid) and commercial insurance providers and will be comfortable navigating complex coverage policies and billing procedures. 

Key Responsibilities: 

Insurance Verification & Eligibility 

• Confirm eligibility for both state and commercial plans prior to appointment 
• Communicate additional information needs and necessary corrections to Managers. 
• Document and communicate coverage details and patient responsibilities clearly. 
• Load covered services for preventative appointments 

Claims Management 

• Prepare and submit dental insurance claims accurately and timely. 
• Prepare and submit Prior Authorizations accurately and timely. 
• Communicate necessary corrections to providers prior to submission 
• Investigate and resolve overdue claims 

Patient Communication 

• Explain insurance benefits, co-pays, deductibles, and out-of-pocket costs. 
• Assist patients with questions regarding their coverage and billing. 

Coordination with Clinical and Front Office Teams 

• Ensure treatment plans are aligned with insurance coverage. 
• Collaborate with providers to obtain necessary documentation for claims. 
• Maintain accurate patient records and billing information. 

Compliance & Documentation 

• Stay current with insurance regulations and dental coding standards. 

Ensure HIPAA compliance in all patient communications and data handling 

Qualifications: 

• High school diploma or equivalent; Minimum 2 years of experience in dental insurance coordination or billing. 
• Strong knowledge of Medicaid and commercial dental insurance plans. 
• Proficiency in dental practice management software (e.g., Dentrix, Eaglesoft, Open Dental). 
• Excellent communication, organizational, and problem-solving skills. 
• Ability to work independently and as part of a team in a fast-paced environment.