790 Ridge Rd, Lackawanna, NY 14218, USA Req #495
Friday, January 3, 2025
If you are passionate about making a difference in patients' lives and are dedicated to providing exceptional dental care, we invite you to join our team!
Salary range: $15.59 - $22.50 per hour.
Job Summary:
The Baker Victory HealthCare Center provides high quality and affordable dental care to our patients. We serve a variety of patients from the community, including individuals with intellectual and developmental disabilities or other special needs. The Patient Service Representative will perform front desk responsibilities related to the check-in, check-out, insurance verification, scheduling of patients, and preparing the office for the next day’s patients. This position is fast-paced and high volume, serving up to 100 patients per day.
Essential Job Duties:
- 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.
Specific Roles within the PSR Job Function:
Insurance Verifications:
• 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.
Predeterminations:
• 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.
Billing Review:
• 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.
Documentation Review:
• 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.
Booking Appointments:
• 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.
Skills:
• Computer/database Experience (Eaglesoft)
• Customer Service skills
• Multi-tasking skills
• Knowledge of dental procedures
Minimum Education Required:
High School Diploma (Associate’s Degree preferred)
Minimum Experience Required:
1-2 years of administrative experience, dental office experience preferred
License/Registration/ Certifications Required:
- None
Training Requirements:
- New Hire Orientation
Physical Requirements:
• The overall nature of the position is sedentary requiring little physical effort with occasional light physical exertion required. There is little, if any, exposure to environmental conditions.
• The constant physical demands of the position are sitting, talking, hearing.
• The frequent physical demands of the position are standing, walking, climbing, repetitive motions, and eye/hand/foot coordination.
• The occasional physical demands of the position are lifting, carrying, pushing, pulling, balancing, stooping, crouching, reaching, handling, grasping, and feeling.
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