Pre-Authorization and Insurance Specialist

The Pre-Authorization and Insurance Specialist is responsible for verifying insurance eligibility, benefits, and treatment history as well as processing and coordinating all referrals and coverage determinations for dental procedures.

What You Will Do

Verifying insurance eligibility, benefits, and treatment history, processing and coordinating referrals and coverage determinations, and communicating with patients and staff to resolve insurance-related issues.

Why It Might Be a Fit

The ideal candidate will have strong analytical skills, proficiency in electronic health records, and the ability to communicate effectively with patients and staff.

Requirements

• High School Diploma
• Two (2) years' experience in a dental support role, or certified dental biller, pre-authorization specialist, or insurance coordinator role in a healthcare setting
• Knowledge of insurance verification and authorization processes for dental services
• Understanding of payer guidelines and frequency limitations
• Strong analytical skills to review benefit coverage and identify payer-specific requirements
• Proficiency creating, using, and maintaining electronic health records
• Ability to communicate effectively with patients and staff to resolve insurance-related issues
• Ability to develop and effectively maintain relationships with vendors/providers
• Must demonstrate and competently understand the sensitivity and confidentiality status of the patients’ information
• Must demonstrate an understanding of medical terminology
• Must possess valid driver’s license
• Must adhere to the Confidentiality and HIPAA policies
• Skilled with working in a complex work environment
• Ability to maintain confidentiality at all times and maintain organizationally appropriate relationships
• Knowledge of organization policies and procedures
• Knowledge of computers, systems, and applications
• Skilled in exercising initiative, appropriate judgment, problem-solving and decision making
• Skilled in developing and maintaining effective relationships with patients, customers, and other staff