Insurance Coordinator
2 months ago
**Job description**
**Responsibilities**:
- Maintain thorough documentation of patient records for any procedures necessitating prior approval.
- Utilize the established system to process pre-approved cases daily, following completion of treatment planning by the doctors.
- Abide by specified protocols to secure claim approval and prevent claim denials.
- Communicate and collaborate with treating doctor to rectify any inaccuracies in clinical notes, including diagnosis, procedure codes, tooth numbers, and treatment times.
- Inform reception and medical departments promptly of approved claims to facilitate appointment scheduling.
- Work alongside the cashier to ensure patients' insurance card details are accurate and up to date before their appointment with the dentist.
- Conduct follow-up inquiries with insurance companies regarding denied claims and seek justification for the denials.
- Resubmit denied claims after reviewing the denial codes provided by insurance companies.
- In the event of repeated claim denials, consult with the treating dentist and the Chief Medical Officer to determine appropriate measures.
- Update patient records to reflect final denied claims and communicate this information to the treating dentist and patient accordingly.
- Invoice daily procedures performed and prepare submissions for covered insurance companies and self-paying patients.
- Process insurance claims accurately and in a timely manner, following established protocols and guidelines.
- Verify insurance coverage and eligibility for patients, and communicate effectively with insurance companies to resolve any issues.
- Collaborate with healthcare providers and patients to obtain necessary documentation and information for claims processing.
- Review and update patient records to ensure accuracy and completeness of insurance information.
- Educate patients on insurance coverage, benefits, and payment options, and address any questions or concerns they may have.
- Maintain confidentiality of patient information and comply with HIPAA regulations and other relevant laws and policies.
- Assist with billing and coding tasks as needed, and provide support to other administrative staff as required.
**Qualifications**:
- Minimum of 2 year of experience in insurance coordination or a related field, preferably in a healthcare setting.
- Strong understanding of insurance procedures, terminology, and regulations.
- Excellent communication and interpersonal skills, with the ability to interact effectively with patients, insurance companies, and healthcare providers.
- Detail-oriented and organized, with the ability to multitask and prioritize tasks effectively.
- Knowledge of medical billing and coding processes is a plus.
- Bachelor's degree in healthcare administration, business administration, or a related field is preferred.
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