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Overview:
The Insurance Coordinator is responsible for the ongoing documentation requirements of new and existing patients insurance benefits verification to ensure accurate treatment estimates.
Responsibilities:
Core duties and responsibilities include the following. Other duties may be assigned.
- Liaise with insurance providers to elucidate patients' coverage and to resolve disputes about rejected claims
- Prioritizes and processes incoming Insurance Verifications, Referrals, and Prior Authorization requests
- Verifies member/patient eligibility
- Ensures insurance carrier documentation requirements are met
- Understands and can explain dental and medical insurance plan benefits.
- Effectively communicate with others, including physician offices, insurance companies, patients, and others about insurance benefits and costs associated to procedures.
- Handles multiple assignments or pieces of work at one time. The capability of working within a stressful environment under consistent deadlines, pressures and interruptions.
Qualifications:
To perform this job successfully an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.
EDUCATION:
High school diploma or equivalent
EXPERIENCE:
Knowledge of dental/medical benefits and breakdowns a plus
Proficient computer skills
COMPETENCIES:
To perform the job satisfactorily, an individual should demonstrate the following competencies:
Technical Skills Assesses own strength and weaknesses; pursues training development opportunities; strives to continuously build knowledge and skills; shares expertise with others
Customer Service Manages difficult or emotional customer situations; responds promptly to customer needs; solicits customer feedback to improve service; responds to requests for service and assistance; meets commitments
Interpersonal Skills Maintains confidentiality; listens to others without interrupting; keeps emotions under control; remains open to others ideas and tries new things
Oral Communications Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions
Written Communication Writes clearly and informatively; able to read and interpret written information
Quality Management Looks for ways to improve and promote quality; demonstrates accuracy and thoroughness
Diversity Shows respect and sensitivity for cultural differences; promotes a harassment-free environment
Ethics Treats people with respect; keeps commitments; inspires the trust of others; works with integrity and ethically; upholds organizational values
Organizational Support Follows policies and procedures; completes administrative tasks correctly and on time; supports organizations goals and values; respects diversity
Planning/Organizing Prioritizes and plans work activities; uses time efficiently
Professionalism Approaches others in a tactful manner; reacts well under pressure; treats others with respect and consideration regardless of their status or position; accepts responsibility for own actions; follows through on commitments
Quality Demonstrates accuracy and thoroughness; monitors own work to ensure quality
Safety and Security Observes safety and security procedures; reports potentially unsafe conditions; uses equipment and materials properly
Adaptability Adapts to changes in the work environment; manages competing demands; changes approach or method to best fit the situation; able to deal with frequent change, delays, or unexpected events
Attendance/Punctuality Is consistently at work on time; ensures work responsibilities are covered when absent; arrives at meetings and appointments on time
Dependability Follows instructions, responds to management direction; takes responsibility for own actions; keeps commitments; commits to long hours of work when necessary to reach goals; completes tasks on time or notifies appropriate person with an alternate plan