Dental Operations Rep

The Dental Operations Representative or Dental Administrative Operations Representativewill work with an established team of dentists, dental assistants, dental residents and administrative staff. The dental clinic is fast paced and candidates must be able to multitask. Position requires the following; courteous communication with the families and dental clinic staff, scheduling appointments, patient registration, insurance verification/authorization, dental software experience as well as other general front office duties as assigned.

This position reports to the Dental Clinic Operations Supervisor or Clinic Operations/Practice Manager. Provide patient services and administrative support in dental clinic operations. Interacts with parents, patients, physicians and other staff under moderate supervision in a courteous manner. Provide assistance to other employees within their department as well as other departments. Collect and verify all demographic information to ensure accuracy. May provide required notification of scheduled services according to dental care requirements. Responsible for scheduling patients for dental specialty appointments. Position requires rotating between phone, front Desk and chart prep. Next step in career ladder is Senior Clinic Operations Rep or Team Lead position.

Minimum Education
High School Diploma or GED .

Minimum Work Experience
1 year related dental experience required.
1 year experience performing billing, patient registration, scheduling, dental and medical insurance verification required.

Required Skills/Knowledge
Broad dental clinic knowledge, customer service skills and of general administrative and clerical procedures, Experience working with dental software programs and Microsoft Office. Knowledge of dental terminology, procedures and diagnosis along with a working knowledge of dental insurance. The ability to type a minimum of 35 words per minute is required

Functional Accountabilities
Patient Services

• Demonstrate accuracy of scheduling patients using the applicable scheduling system for the department.

• Complete computer aided, on-line registration screen with parent/guardian via telephone or in person in professional & courteous manner.

• Collect accurate demographic and insurance information. Update systems as needed in accordance with department standards for registration accuracy.

• Reschedule appointment for patients who did not show or for the ancillary services cancellations by providers/dental assistants. Schedule follow up appointments at check out.

• Greet patients and parents courteously. Arrive patient in appropriate system based on department policy.

• Obtain required consents for department & ensure distribution of compliance related materials (i.e. HIPPA Privacy Notice, Patient Rights). Obtain copy of insurance card and photo ID to be stored in medical and dental record (copy or scan activity required). Ensure applicable insurance company and CNMC HIM department receive copies of appropriate forms/documentation. Complete all documentation in accordance with department policy and procedure.

Information Verification

• Verify insurance eligibility using applicable eligibility system. Ensure managed care carve outs (lab and radiology carve outs) are adhered to.

• Notify parents of the need for completed insurance referral form or pre-authorization prior to scheduled/unscheduled appointments.

• Discuss co-payment, deposits, payment in full, or past due balance collections with parents prior to scheduled appointment in a professional & courteous manner.

• Counsel parents or refer parent to Financial Information Center (FIC) for establishing payment schedule or method of payment.

• Verify insurance information is complete prior to procedure and collect and verify pre-authorization/referral information: goal is to obtain authorizations 5 days in advance of service.

• Utilize all systems where patient information may be stored (EPRS, SCI, Cerner, IDX, McKesson, etc.) to verify that systems are in sync.

Cash Collection

• Collect and record co-payments, deposits and payments in full and provide payer with receipt. Responsible for helping department meet 85% of the collection target for the department.

• Maintain departmental requirements regarding cash controls and collections.

Billing Preparation

• Reconcile schedules for upcoming dental session to include ensuring that accounts are set up for billing and services requiring authorization are completed. Activity should be completed 3-4 days in advance of clinic session; Areas with procedures requiring authorizations work standard may be 5-7 days.

• Appropriately clear all emergency walk in's and ensure scheduled/unscheduled appointments are recorded into scheduling system.

Office Support

• Answer telephone and address caller needs appropriately. Avoid transferring calls for better service to families. Meet department standards relative to ACD policies if applicable. Manage voice mail messages within same business day.

• All staff are responsible for information distributed via e-mail. Staff should check work email a minimum of 3 times daily and respond to inquiries within 24 hours (or next business day).

• Maintain office files and office supplies at PAR levels.

• Maintain clean reception area and work space.

• Other support as needed.