Dental Claims Coordinator- Special Needs Clinic

Responsibilities

• Prepares and submits insurance claims and pre-authorizations (electronic and paper); monitors all unsubmitted or denied claims.
• Identifies and resolves payment issues proactively, coordinating with payers to obtain claim approvals.
• Audits patient records for accurate financial and CDT coding documentation; initiates corrections and communicates with providers to ensure compliant submissions.
• Collaborates with the hospital to create a streamlined process (create and monitor PAs, insurance coordination, and hospital coordination).
• Assists students, residents, and staff in understanding insurance protocols.
• Maintain 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.

Qualifications

• High School Diploma or GED.
• Four (4) years of public and private dental claims processing; OR Associate’s Degree and two (2) years of public and private dental claims processing.