Dental Treatment Coordinator - University of Rochester
Rochester, NY
About the Job
Responsibilities
**Position Summary** :
Responsible for comprehensive medical/dental case coordination at Clinton Crossings including, but not limited to, treatment planning with faculty provider(s), coordination of medical necessity documentation, acquisition of dental/medical pre-authorization, performs medical claim submission and any required follow-up. Responsible for considerable departmental administrative details requiring extensive knowledge and experience with medical/dental billing for prosthodontics, periodontics, orthodontics, oro-facial pain, oral surgery and implant services. Responsible for ensuring accurate and timely flow of treatment information. Responsible for patient financial counseling, regular monitoring of medical/dental account balances and the resolution of any complications. Principle liaison between patient, provider and insurance company.
**Supervision and Direction Exercised** :
Responsible for monitoring own performance on assigned tasks against procedural standards. Self-directed. Must make complex decisions independently and provide structured direction to front end staff to achieve desired outcomes. Responsible for working with Practice Administrator, Sr. Administrator and Dental Central Billing Office to ensure account accuracy and resolution of account balances in a timely manner.
**Machines and Equipment Used** :
Personal computer, Box.com, fax machine, photocopier, telephone
**Responsibilities:**
20% Exercising tact, initiative and independent judgment makes decisions using approved Departmental procedures regarding treatment planning and security of complex, high dollar, comprehensive medical cases. Communicates directly to patient, provider(s) and insurance company.
20% Above average knowledge of insurance and referral requirements. Contacts insurance companies to prior authorize treatment procedures. Confers with Providers to obtain greater specificity and/or clarification on possible diagnoses. May need to involve provider in communication with the insurance company should more medical information be needed or if authorization is transferred to medical review.
20% Review all medical necessity letters for accuracy, creates individual treatment estimates for each medical case and prints diagnostic information for claim submission to insurance. Inputs medical claim data into computer for billing purposes and ensures integrity of claim data.
10% Uses thorough knowledge of edit logic to assign appropriate codes. Understands third party payers to verify the selection of appropriate codes and sequencing, including modifier assignment.
10% Monitor all active medical/dental accounts on regular basis addressing any and all concerns relating to prompt authorization, patient financial obligations, insurance reimbursements and related duties.
10% Responds immediately to all insurance requests for additional information and handles all related patient inquiries.
5% Provide treatment providers and other staff with information relative to any pre- payment requirements and payment arrangements.
5% Prepares reports as requested and related clerical tasks.
**Qualifications:**
Associate’s degree in business field and 4-5 years of experience in billing, accounting, and/or coding; or an equivalent combination of education and experience. Preferred: Minimum of two years pro fee billing and collections for dental or physician office setting preferred, or equivalent combination of education and experience. Superior customer service skills. Knowledge of CDT and/or CPT and ICD-10-CM required.
The University of Rochester is committed to fostering, cultivating, and preserving a culture of equity, diversity, and inclusion to advance the University’s mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other status protected by law. This commitment extends to the administration of our policies, admissions, employment, access, and recruitment of candidates from underrepresented populations, veterans, and persons with disabilities consistent with these values and government contractor Affirmative Action obligations.
**How To Apply**
All applicants must apply online.
_EOE Minorities/Females/Protected Veterans/Disabled_
**Pay Range**
Pay Range: $ 18.50 - $ 24.05 Hourly
_The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job’s compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations._
**Location:** Eastman Dental Center
**Full/Part Time:** Full-Time
**Opening:** Full Time 40 hours Grade 009 UDFG Dental Faculty
**Schedule:** 8 AM-5 PM
Source : University of Rochester