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Case & Program Coordinator-Oral Surgery Clinic
Case & Program Coordinator-Oral Surgery Clinic
Memphis, TN, United States
Job Identification: 1569
Job Category: Administrative
Posting Date: 02/11/2025
Job Schedule: Full Time
Locations: 875 Union Avenue, Memphis, TN, 38163, US (On-site)
Job Description
Market Range: 06
Hiring Salary: $20.00/Hourly
JOB SUMMARY/ESSENTIAL FUNCTIONS: The Care and Program Coordinator supports insurance-related revenue functions and ensures compliant billing and collections procedures. This position acts as a subject matter expert related to medical and dental CDT coding and offers guidance and directives to residents, faculty, and staff.
Responsibilities
DUTIES AND RESPONSIBILITIES:
- Verifies patient insurance eligibility and benefits utilizing internet resources or manually procuring information from the insurance carrier.
- Performs daily insurance eligibility verification. Notifies providers of eligibility restrictions, patient financial obligations, and provides directives on the use of compliant CDT coding.
- Conveys information regarding procedure codes and diagnostic codes to receive correct referrals for office visits and authorizations for inpatient and outpatient hospital procedures.
- Performs daily audits on patient health records to ensure financial and coding accuracy including the presence of complete and compliant chart documentation; initiates corrections and communicates errors to providers and staff; requests additional information or documentation as needed; monitors and notifies providers of missing charges.
- Proactively resolves payment issues by anticipating and identifying problems and coordinating appropriate solutions before claim submission; corrects fees on accounts as needed before claim submission; responds to payor requests for additional information for pending claims.
- Generates, researches, analyzes, and resolves aged insurance balances.
- Communicate processes with patients seeking reimbursement and support efforts in an effective and timely manner.
- Obtains all referrals and authorizations for office visits, procedures, and hospital inpatient/outpatient procedures.
- Creates and mails monthly statements to patients.
- Adheres to HIPAA guidelines when handling patient information and ensures HIPAA forms are signed in the billing systems.
- Maintains industry expertise in CDT coding and compliance as well as insurance regulations and billing procedures.
Qualifications
MINIMUM REQUIREMENTS:
EDUCATION: High School Diploma or GED. (TRANSCRIPT REQUIRED)
EXPERIENCE: Four (4) years of public and private dental claims processing; OR Bachelor's Degree in lieu of experience.
KNOWLEDGE, SKILLS, ABILITIES:
- Knowledge of private medical/dental insurance billing policies.
- Expert knowledge of medical/dental terminology, treatment planning, and CDT coding.
- Knowledge of accounts receivable and collections processes.
- Ability to manage multiple job priorities and tasks efficiently, effectively, and accurately while demonstrating close attention to detail.
- Ability to communicate professionally and courteously with faculty, residents, students, patients, and staff.
- Ability to identify, research, and/or resolve financial conflicts with insurance companies and patient accounts.
- Ability to support and contribute to a positive and productive team environment.
WORK SCHEDULE: This position may occasionally be required to work weekends.
About Us
To apply, visit https://fa-ewlq-saasfaprod1.fa.ocs.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_1/job/1569/?mode=location
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