Bayside Solutions · 21 hours ago
Dental Access Referral Coordinator
United States
Contract
Remote
Entry, Mid Level
$48K/yr - $56K/yr
1+ years expBayside Solutions is seeking a Dental Access Referral Coordinator responsible for managing dental referrals and provider relations. The role involves ensuring members are matched with appropriate dental providers and providing support to various internal teams.
Telecom & CommunicationsHuman ResourcesAppsInformation TechnologyStaffing AgencyTelecommunicationsVirtual Reality
No H1B
Responsibilities
Receive and process referral requests and authorizations from members, primary care dentists, medical providers, and internal departments
Review referral submissions for completeness and ensure all required documentation is obtained
Facilitate referral requests and authorization determinations in accordance with established policies
Provide referral assistance and guidance to members
Monitor referral queue volumes daily and implement defined escalation processes as needed
Build and maintain strong relationships with network providers to support timely referrals and appointment scheduling
Serve as a subject matter expert on dental health benefits and provider network access
Collaborate with members, providers, and internal departments to improve referral workflows and member experience
Support provider recruitment, contracting, onboarding, and specialty provider engagement
Train and onboard the dental provider office staff on our policies and procedures
Maintain and update resources related to dental coding terminology, documented workflows, provider lists, and availability data
Track and report general and specialty provider access metrics
Identify, analyze, and escalate emerging access barriers and network trends to the Dental Benefits Manager
Qualification
Required
Bachelor's degree in Business Administration, Health Care Administration, Social Sciences, or a related field required
One (1) to three (3) years of experience in a clinical or healthcare setting
Intermediate verbal and written communication skills
Intermediate proficiency with personal computers and Microsoft Office Suite applications (Outlook, Word, Excel, Teams, PowerPoint)
Intermediate meeting management and facilitation skills
Basic knowledge of managed care principles and operations
Working knowledge of provider and network operations
Extensive knowledge of conflict resolution and process improvement principles
Extensive knowledge of healthcare billing practices, preferably related to dental services
Ability to work collaboratively and maintain cooperative working relationships
Ability to adapt to changing priorities and requirements
Ability to professionally represent the health plan in public and provider-facing settings
Demonstrated ability to interpret complex regulations, analyze issues, and implement sound recommendations
Ability to serve as a resource to others regarding relevant laws and regulations
Preferred
Dental referral management
Referral processing and authorization
Dental provider network access
Provider relations management
Care coordination support
Customer support collaboration
Claims and provider services coordination
Healthcare workflow management
Member assistance and guidance
Referral queue monitoring and escalation
Appointment scheduling coordination
Dental benefits expertise
Managed care principles
Provider network operations
Provider recruitment and onboarding
Provider contracting support
Specialty provider engagement
Provider training and education
Dental coding terminology
Healthcare billing practices (dental)
Documentation review and compliance
Resource and workflow documentation
Provider data and availability management
Access metrics tracking and reporting
Network access analysis
Access barrier identification and escalation
Process improvement
Conflict resolution
Cross-functional collaboration
Regulatory interpretation and compliance
Healthcare policy application
Microsoft Office (Outlook, Word, Excel, Teams, PowerPoint)
Meeting facilitation
Data analysis
Relationship building
Adaptability to changing priorities
Professional representation of health plans
Company
Bayside Solutions
Bayside Solutions is a staffing and recruiting company offering IT, telecom, and scientific staffing services.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
B
Bob Klotz
Founder
Company data provided by crunchbase