Job Description

A

Dental Insurance Coordinator

is a vital member of a dental practice's administrative team, acting as the primary liaison between the dental office, patients, and insurance companies. Their main goal is to

maximize insurance reimbursements

and

ensure accurate financial information

for patients.

Key Responsibilities

Insurance Verification & Eligibility:

Verify patient insurance benefits

accurately and efficiently by contacting insurance providers, using online portals, or through other communication channels.

Determine patient eligibility

for dental services and understand coverage details, limitations, and deductibles.

Obtain pre-authorizations or pre-determinations

for specific treatments as required by insurance plans.

Claims Processing & Submission:

Prepare, submit, and track dental insurance claims

accurately and in a timely manner. Ensure all necessary documentation (X-rays, narratives, charting) is included with claims.

Follow up on outstanding claims

with insurance companies to ensure prompt payment.

Resubmit denied or rejected claims

with corrected information.

Patient Financial Communication:

Explain insurance benefits, coverage, and potential out-of-pocket costs

to patients clearly and concisely.

Provide accurate treatment plan estimates

to patients, outlining insurance coverage and patient responsibility. Assist patients with understanding their dental benefits and how they apply to their treatment.

Billing & Payments:

Post insurance payments and adjustments

accurately into the practice management software.

Manage patient accounts receivable

, including billing patients for their portion of costs. Follow up on overdue patient balances and assist with payment arrangements. Process refunds when necessary.

Record Keeping & Administration:

Maintain accurate and up-to-date patient insurance information

in the practice management system. Keep detailed records of all insurance communications, claims, and payments. Generate reports related to insurance claims, payments, and accounts receivable. Stay informed about changes in insurance policies, procedures, and billing codes.

Collaboration:

Work closely with dentists, hygienists, and other dental staff to ensure smooth patient flow and accurate treatment coding. Communicate effectively with insurance company representatives to resolve issues and discrepancies.
Qualifications and Skills

Education:

High school diploma or GED is typically required. A certificate or associate's degree in healthcare administration or a related field may be preferred.

Experience:

Previous experience in a dental office setting is highly desirable. Experience with dental insurance verification, claims processing, and billing is essential. Familiarity with dental practice management software (DOK32) is often required.

Skills:

Excellent communication skills

(verbal and written) to effectively interact with patients and insurance providers.

Strong attention to detail and accuracy

is crucial for data entry and claims processing.

Proficiency in data entry and computer skills

, including Microsoft Office Suite.

Knowledge of dental terminology, procedures, and common insurance billing codes

(e.g., CDT codes).

Understanding of various dental insurance plans

(PPOs, HMOs, FFS) and how they work.

Organizational and time management skills

to handle multiple tasks and prioritize effectively.

Problem-solving abilities

to resolve claim denials and billing issues.

Customer service orientation

to assist patients with financial concerns. Ability to work independently and as part of a team.
A skilled Dental Insurance Coordinator is instrumental in ensuring the financial health of a dental practice while providing patients with clear and transparent information about their treatment costs.

Job Type: Full-time