Dental Insurance & Pre-Authorization Specialist

Western Wayne Family Health Centers; Dearborn (MI); Vor Ort; USD 42.000 - 65.000; Vollzeit

Zusammenfassung

Western Wayne Family Health Centers in Dearborn, MI seeks an experienced Pre-Authorization and Insurance Specialist to verify insurance eligibility and benefits for dental procedures, coordinate referrals, and ensure timely determinations. You will interface with providers, billing, and patients to secure approvals and maintain accurate EHR records.

Primary duties include reviewing treatment plans and codes, submitting authorizations, and tracking expirations while maintaining strict

Qualifikationen

• High School Diploma required.
• Two years dental support/insurance coordination experience preferred.
• Experience with insurance verification and authorizations for dental services.

Aufgaben

• Verify insurance eligibility, benefits and limitations before procedures.
• Submit referrals, prior authorizations, and predeterminations to insurers.
• Maintain accurate records in the EHR and tracking logs.
• Communicate determinations and treatment plans to patients and staff.
• Coordinate with providers, billing, and front desk to meet authorization requirements.
• Follow HIPAA and confidentiality policies at all times.
• Respond to calls and inquiries regarding determinations or benefits.
• Cross-train with billing staff to support workflows.

Kenntnisse

Insurance verification

Authorization processes

Payer guidelines

Benefit analysis

EHR proficiency

Patient communication

Vendor relationships

HIPAA confidentiality

Medical terminology

Driver's license

Complex environment

Problem-solving

Decision making

Time management

Ausbildung

High School Diploma

Certified dental biller (optional)

Tools

IDentalSoft

Athena

EPIC

Jobbeschreibung

Western Wayne Family Health Centers in Dearborn, MI seeks an experienced Pre-Authorization and Insurance Specialist to verify insurance eligibility and benefits for dental procedures, coordinate referrals, and ensure timely determinations. You will interface with providers, billing, and patients to secure approvals and maintain accurate EHR records.

Primary duties include reviewing treatment plans and codes, submitting authorizations, and tracking expirations while maintaining strict