Insurance Verification Specialist
1 week ago
The Insurance Verification Specialist is responsible for knowledge of dental insurance verification and billing as well as partnership with third party vendors to efficiently alleviate workload from the offices. The role will audit vendor performance of insurance verification, communicate discrepancies, and provide coaching on insurance verification processes within the PMS (Practice Management System). The Insurance Verification Specialist will also review monthly invoices and analyze accuracy with the services completed.
To perform this job successfully, an individual must be able to perform each essential job duties satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
ESSENTIAL JOB RESPONSIBILITIES
- Lead third party vendor through entire insurance verification life-cycle
- Act as liaison between third party insurance verification vendor and dental practices
- Organize necessary office information and insurance resources for proper insurance verification
- Communicate processes to insurance verification team as needed by changes in the company's standard operating procedures
- Audit data received from insurance with the data entry in the PMS
- Communicate consistently with insurance verification team on errors to obtain less than two (2%) error rate
- Report on insurance verification metrics including accuracy rates, costs, and overall performance
- Partner with claims processing and insurance follow-up teams for continuous improvement efforts with insurance verification implementation
- Ensure compliance with HIPAA and other relevant regulatory requirements
OTHER JOB RESPONSIBILITIES
- Provide feedback on process improvement opportunities
- Work with Revenue Cycle and Operations
- Collaborate with field on processes, policies and streamlining processes
- Complete projects and ensure deliverables and timelines are met
- Provide clear and concise updates, calling out risks
QUALIFICATIONS:
- Excellent communication skills, both written and verbal. Ability to interact at all organizational levels.
- Strong problem-solving skillset.
- Self-starter who excels in a fast paced, data driven environment.
- Knowledge of Dental Practice Management Systems – Dentrix Core & Ascend
- Must be proficient in MS Office tools
REQUIRED EDUCATION AND EXPERIENCE:
- High School diploma or equivalent required. Associates degree preferred
- Three to five (3-5) years insurance verification experience preferred with knowledge of dental bill generation and claims processing
- Strong Microsoft Excel skills required
PHYSICAL REQUIREMENTS:
- General Office Activities as Required
- Sitting and Typing for Long Periods
The above statements are intended to provide a general overview and level of work being performed by most people assigned to this job. They are not intended to be a list of all responsibilities, duties and requirements. Additional duties can be assigned as determined.
Elite Dental Partners is an Equal Opportunity/Affirmative Action Employer. We support a diverse workforce.
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