Insurance Coordinator

Title: Insurance Coordinator 
Practice: Oral Surgery Implant Specialist 
Location: Dakota Dunes, SD
Hours: 

Position Purpose:

An insurance coordinator plays a critical role within our oral surgery practices. The Insurance Coordinator is responsible for overseeing and managing all insurance-related activities within the organization. This includes processing claims, verifying insurance coverage, handling patient or client inquiries, and ensuring compliance with relevant regulations. The role requires strong communication skills, attention to detail, and the ability to work effectively with various stakeholders, including patients, insurance companies, and healthcare providers.

Essential Functions

Patient Interaction and Support:

• Greet and welcome patients upon arrival.
• Assist patients with check-in and check-out processes.
• Provide information on clinic policies, procedures, and services.
• Answer patient phone calls and address inquiries promptly and professionally.
• Schedule and confirm patient appointments, ensuring optimal appointment utilization.
• Monitor schedules for patient cancellations and follow-up with patients that need to reschedule.

Administrative Duties:

• Maintain and update patient records in the electronic health record (EHR) system.
• Coordinate referrals, diagnostic tests, and follow-up appointments.
• Verify patient insurance information and manage prior authorization processes.
• Handle billing and payment processes, including collection of co-pays and outstanding balances.
• Prepare and manage patient forms and documentation.
• Other duties as assigned by the practice administrator.

Insurance Verification and Authorization:

• Verify patient insurance coverage and benefits.
• Obtain pre-authorizations and referrals for services as required by insurance providers.
• Ensure that all necessary documentation is completed accurately and submitted in a timely manner.

Customer Service:

• Always maintain a high standard of customer service and professionalism.
• Address patient complaints and escalate issues to management when necessary.
• Strive to create a positive and supportive environment for patients and their families

Collaboration and Coordination:

• Serve as a liaison between patients, healthcare providers, and other staff members.
• Communicate effectively with clinical staff to ensure patient needs are met.
• Facilitate communication regarding patient care plans and instructions

Compliance and Record Keeping:

• Maintain up-to-date knowledge of insurance regulations and compliance requirements.
• Ensure that all activities comply with relevant laws, regulations, and organizational policies.
• Maintain accurate and organized records of insurance transactions and communications..

Qualifications

Education:

• High school diploma or equivalency, required.
• Certification in medical billing and coding or a related area is a plus.

Experience:

• Previous experience in insurance coordination, medical billing, or a related field is highly desirable.
• Familiarity with healthcare insurance policies, procedures, and regulations.
• Knowledge of relevant regulations and compliance requirements in healthcare.
• Bilingual (English/Spanish) candidates are strongly preferred to help provide exceptional patient care and communication

Performance Requirements:

• Approachable, professional demeanor
• Strong communication and interpersonal skills.
• Detail-oriented and thorough in task execution.
• Excellent organizational and multitasking abilities.
• Proficiency in using relevant software and systems for claims processing and record keeping.
• Knowledge of medical terminology and healthcare practices.
• Ability to work in a fast-paced environment and handle stressful situations with professionalism.
• Empathetic and patient-focused approach to care coordination.
• Independent decision-making skills and utilization of sound judgement.

• We offer Medical, Dental, and Vision Insurance plans to our full-time employees.
• Two out of the three medical plans offered include Health Savings Account (HSA) eligibility.
• Company-paid Life, AD&D and Long-Term Disability coverage.
• Additional Voluntary Life and AD&D Insurance for you and your family!
• Voluntary Short-Term Disability Insurance available to you as well
• Dependent Care Flexible Spending Account (FSA) offered.
• Immediately begin saving for retirement through our 401(k) starting with very first paycheck!
• Employer 401(k) contribution and Profit Sharing after six months of employment
• PTO and 8 Paid holidays for fulltime employees!

DISCLAIMER

The above statements are intended to describe the general nature and level of the work being performed by people assigned to this work.  This is not an exhaustive list of all duties and responsibilities.  OPS’s management reserves the right to amend and change responsibilities to meet business and organizational needs as necessary.