Special Needs Dental Claims Specialist

UT Health Sciences; Memphis (TN); On-site; USD 53,726,000 - 57,859,000; Full time

Job summary

UT Health Sciences is seeking a Dental Claims Coordinator for the Special Needs Clinic to oversee dental insurance billing, claims processing, and provider credentialing for AEGD, UDP, and Special Needs Clinic.

The role emphasizes timely claims, pre-authorizations, and CDT code accuracy for services common to patients with special health care needs, including hospital-based dentistry and sedation.

Qualifications

• Ability to organize and prioritize work to meet deadlines.
• Knowledge of special needs patient population guidelines, regulations, policy, and procedures.
• Knowledge of public and private dental insurance billing policies.
• Ability to manage multiple job priorities and tasks efficiently, accurately, and with attention to detail.
• Expert knowledge of dental terminology, CDT coding, accounts receivable and collections processes.
• Ability to communicate professionally with faculty, residents, students, patients and staff.
• Ability to identify, research and resolve financial conflicts with insurance companies and patient accounts.

Responsibilities

• Prepares and submits insurance claims and pre-authorizations; monitors unsubmitted or denied claims.
• Identifies and resolves payment issues, coordinating with payers to obtain claim approvals.
• Audits patient records for accurate financial and CDT coding documentation; initiates corrections and communicates with providers.
• Collaborates with the hospital to streamline processes (PA creation, insurance coordination, hospital coordination).
• Assists students, residents, and staff in understanding insurance protocols.
• Keeps up-to-date knowledge of CDT coding, Medicaid/Medicare rules, and payer regulations for dentistry.
• Explains treatment costs and insurance coverage.
• Performs other duties as assigned.

Skills

Organizational skills

Prioritization

Special needs guidelines

Dental insurance billing

CDT coding proficiency

Accounts receivable

Professional communication

Insurance dispute resolution

Education

High School Diploma or GED

Associate’s Degree with 2 years experience

Job description

UT Health Sciences is seeking a Dental Claims Coordinator for the Special Needs Clinic to oversee dental insurance billing, claims processing, and provider credentialing for AEGD, UDP, and Special Needs Clinic.

The role emphasizes timely claims, pre-authorizations, and CDT code accuracy for services common to patients with special health care needs, including hospital-based dentistry and sedation.