Dental Insurance Trainer

3 weeks ago

Morrisville North Carolina, United States Affordable Care LLC Full time
Overview:
Position Summary:

The Insurance Trainer/Auditor shares their expertise and gives advice to ACI affiliated practice staff with the aim of optimizing Dental commercial insurance and Dental Medicaid participation.  This position will be responsible for routine chart audits to ensure compliance with all third party payor contractual agreements. The Insurance Trainer/Auditor also provides training and on-going assistance to practice staff and other support personnel to ensure practice level proficiency in plan administration and revenue maximization. 

Responsibilities:
Position Duties and Responsibilities:

Review patient ledgers in the practice management software system to verify correct billing processes and confirm clinical records are complete.

Identify and report breaches in protocol.

Schedule and lead remedial Medicaid/insurance training of the clinic staff, when needed.

Keep abreast of all policy and coverage changes including reimbursement rules, and the laws and regulations governing billing and collection activities.

Responding to insurance related questions/requests from the field teams in a quick and efficient manner, requiring keen understanding of plan policies and all revenue cycle functions. Including but not limited to: Enrollment, Eligibility &Verification, Claims Processing, Insurance and Patient Accounts Receivable processes.

Enter fee schedules, plans and fee updates for insurance and Medicaid plans into Dentrix.

Ability to work independently and collaboratively within a team environment.

Troubleshooting and resolving practice issues related to plan policy, coverage; Dentrix and technological interfaces.

Log all daily tasks as well as practice calls and emails taken in Sales Force.

Perform other duties as new opportunities arise and/or as assigned.

 

Qualifications:
Qualifications

Ability to interpret and effectively communicate insurance regulations.

Excellent verbal and written communication skills.

Ability to facilitate telephone, in-person, and/or web-based training sessions.

Excellent problem-solving skills.

Well organized, accurate, and thorough.

Adaptable; readily adjusts work schedule to adhere to changes in the work environment and able to manage competing demands.

Adept at prioritizing, planning work activities, and developing reasonable action plans.

Proficiency in all Microsoft Office products.

 

Education and Experience Requirements:

Associates degree required; bachelor’s degree preferred.

Minimum five years commercial insurance or Medicaid experience preferred.

Dental coding and billing experience preferred.

 

Computer Skills:                                                            

Proficiency in a Microsoft Windows environment.

Proficiency with dental or medical software; Dentrix preferred.

 

Core Competencies: To perform the job successfully, an individual should demonstrate the following competencies to perform the essential functions of this position. 

High level of customer service orientation.

Ability to assess development needs of affiliated auxiliary practice staff.

Knowledgeable in creating and presenting training course material.

Must possess strong skills in the areas of interpersonal communication, analysis, critical thinking, attention to detail, multi-tasking, and oral & written communication.

Excellent verbal and written communication skills.

Ability to work independently and collaboratively within a team environment.

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