I. SUMMARY
Under general supervision, registers and/or oversees the registration of patients for treatment in a clinic, ensuring that all policies and procedures are observed. Prepares forms, verifies insurance benefits, and explains financial requirements to patients. Manages patient referrals and secures insurance pre-authorizations for dental procedures
II. SKILLS, KNOWLEDGE, ABILITIES, TASKS AND RESPONSIBILITIES
Skills
- Talking to others to convey information effectively.
- Considering the relative costs and benefits of potential actions to choose the most appropriate one.
- Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
- Understanding written sentences and paragraphs in work related documents.
- Actively looking for ways to help people.
- Being aware of others' reactions and understanding why they react as they do.
- Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.
- Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
- Word processing and/or entry skills.
- Organizing and coordinating skills.
- Interviewing skills.
- Skill in preparing and maintaining patient records.
- Ability to multi-task
- Skill in electronic Dental/Medical Records
Knowledge
- Knowledge of dental terminology and procedures.
- Knowledge of general office practices and procedures and record keeping methods.
- Knowledge of planning and scheduling techniques.
- Knowledge of Basic computer usage and programs such as Microsoft office.
- Basic reading and writing skills required.
- Principles, methods, and procedures of hospital financial policies, counseling and guidance.
Ability
- Ability to provide oral and written communication effectively.
- Listen to and understand information and ideas presented through spoken words and sentences.
- Read and understand information and ideas presented in writing.
- Ability to develop and maintain filing systems.
- Ability to make mathematical computations and tabulations accurately and with reasonable speed.
- Apply general rules to specific problems to produce answers that make sense.
- Combine pieces of information to form general rules or conclusions (includes finding a relationship among seemingly unrelated events).
- Tell when something is wrong or is likely to go wrong. It does not involve solving the problem, only recognizing there is a problem.
- Ability to work under pressure.
- Ability to perform standard clinical procedures according to established protocols.
- Ability to represent the organization in a professional manner.
Tasks and Responsibilities
- Confirms patient services needed, schedules evaluations and admissions.
- Records patient demographic, insurance, and billing codes into registration and billing system; research missing information on intake forms; obtains signatures and release forms.
- Provides assistance in the planning, coordination, and implementation of clerical, data entry, and operating procedures within the department.
- Provides general information; receives and directs visitors and/or patients.
- Schedules patient appointments for treatment.
- Confirms services needed by patients, and orients patient to specific dental procedure(s) and nature of treatment involved.
- Enroll and dis-enroll Medicaid patient.
- Follows established departmental policies, procedures, and objectives, continuous quality improvement objectives, and safety, environmental, and/or infection control standards.
- May contact attending physicians regarding services required by patients, evaluations needed and obtain relevant medical records.
- Performs miscellaneous job-related duties as assigned.
- Assist the supervisor as unusual problems arise.
- Assists in processing authorized referrals for enrollees.
- Submit pre-authorizations to dental insurance companies with supporting documentation (x-rays, narratives, periodontal charting, etc.)
- Track and follow up on pending authorizations and referrals
- Communicate approval, denial, or additional information requests to providers and patients
- Ensure those functions are done within the established policies, procedures and guidelines of BHCC.
- Develops and maintains a professional rapport with health care providers in the community (i.e.: physicians, hospitals, ancillary staff and support staff).
- Assist the supervisor as unusual problems arise.
- Support staff in assigned project-based work.
- Monitor fax for new referrals, document attachments, and results to scan into Dentrix or tie to current referrals
- Other duties as assigned by immediate supervisor as required.
III. REQUIREMENTS
- High School Diploma, or equivalent.
- 3-5 years of experience.
- Bilingual preferred.
- Strong interpersonal skills.
- Ability to interact effectively with consumers, administration, faculty, and staff.
- Handle the information with high level of confidentiality.