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OLV Human Services · 5 months ago

Dental Patient Service Representative

790 Ridge Rd, Lackawanna, NY 14218, USA

Full-time

Onsite

Entry Level

$18/hr - $23/hr

1+ years exp

OLV Human Services provides high-quality, affordable dental care to the community, including individuals with special needs. The Patient Service Representative will perform front desk responsibilities related to patient check-in, insurance verification, and appointment scheduling in a fast-paced environment.

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Responsibilities

Answering phones, scheduling and confirming appointments, collect appropriate demographic and insurance information from patient or representative

Performs administrative duties such as copying correspondence, insurance cards, preparing mailings and the collection and distribution of mail and messages

Ensures accurate data entry

Managing patient insurance verifications utilizing other 3rd party payer portals verification systems

Demonstrates friendly, courteous attitude in all communications

Operating computer using dental practice management software, internet and other vendor related programs

Maintain a neat and orderly work environment

Check patients in and out

Runs daily reports consistent with the needs of the dental center

Any other duty as assigned by your Supervisor

Verifies and analyzes insurance plans, benefits, and coverage and updates insurance master in Eaglesoft

Communicates appropriate and relevant information to healthcare center team

Reviews patient accounts and evaluates balances owed; negotiates payment terms collecting outstanding balances prior to next scheduled visit/treatment

Requests, verifies, and scans prior authorizations/referrals

Stays abreast of plan coverage changes educating team members

Coordinates scheduling efforts with department dental professionals

Prepares and submits pre-determination inquiries to 3rd party payers including radiology films and additional clinical documentation

Provides follow up notification to patient on approval or denial of coverage; schedules approved procedures

Prepares patient pre-determination financial responsibility letter according to coverage and plan cost share guidelines; informs patient of financial responsibility

Reviews terms of services with patient, guardian and notifies dental team of the approval or denial of the predetermination

Post payments and denials

Utilizes denial reports to assess root causes of dental claim denials monitor denials for frequency, eligibility, clinical; takes necessary action to correct denial and allow for resubmission and shares findings with all department stakeholders

Monitors specific frequency denials and keeps dental leadership informed

Serves as a Liaison between patient, dental professional, and financial team

Maintains accurate and timely review of clinical documentation against posted charges; engages provider to mitigate documentation and coding errors

Reconciles daily schedules and charges

Creates electronic claim for submission to 3rd party payors

Provides ongoing education on support to the Dental Professionals on changes

Generates daily reports documenting the history of the daily department clinical documentation activities

Responsible for answering phone calls and scheduling patient appointments

Conduct patient pre-certification to ensure coverage for appointments and medical care

Schedule tests, procedures, and referral appointments

Communicate with patients regarding appointments and instructions for procedures and tests