Dental Care Coordinator II
Coordinates the dental treatment of assigned case files. Responsible for ensuring treatment is appropriately planned and managed from initial treatment visit to treatment completion, and all customers are continuously updated and satisfied. Responsible for assisting the team in meeting or exceeding monthly revenue and quality goals.
DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.
- Acts as the Care Coordinator for all parties involved with the claim – the patient, provider’s office/providers’ offices and payer. Consistently communicating with each party/customer, keeping them apprised of the treatment progress, both pre- and post-appointment.
- Meets or exceeds weekly and monthly scheduling and confirmation goals while maintaining superior quality and customer service. Maintains a steady pace throughout the month.
- Accurately estimating treatment dates by line item based on the treatment plan and required healing time between services. Re-estimating or updating each line item for any unscheduled or rescheduled treatment.
- Scheduling treatment appointments as soon as initially authorized and after each subsequent confirmed appointment.
- Confirming services rendered at each appointment. Rescheduling and relinking treatment as required to appropriately manage the file.
- Educating the provider’s office to submit documentation, including the claim, after each appointment within specified timeframes. Following up to obtain documentation and claim if not received.
- Schedules initial treatment appointment by calling the provider and claimant to schedule, faxing the provider authorization, and updating the client with the appointment information.
- Consistently documents treatment progress for each assigned case in the OCCD+D proprietary software in a manner in which any Dental Care Coordinator can reasonably manage the file in the absence of the assigned Care Coordinator.
- Partners with all internal departments to ensure files move forward within established timeframes without sacrificing quality or customer service.
- Escalates unresolved customer issues to Dental Team Supervisor/Manager as appropriate.
- Engages in process improvement strategies by providing constructive feedback on processes, tools and resources; may be required to test new IT applications and/or functionality.
- Prioritizes daily activities in a manner that all assignments are completed Enters new Plans of Treatment, requests pricing & clinical review. Once reviewed and priced, sends the authorization (with supporting documentation) to the client for approval and calls to explain the additional/change in treatment.
- Handles any special payment arrangement with non-contracted providers including pre-pays and discounts/negotiations.
- Responds to the financial team’s requests within 48 hrs. in an effort to process claims received.
- Works all special reports distributed by a supervisor/manager.
- Reviews and responds to any requests from clients, provider, claimant, or supervisor and performs necessary action steps within 48 hrs.
- Consistently demonstrates a positive attitude and an overall commitment to excellence and is a team player.
- Actively participates in continuous operational improvements. Specific activities include, but are not limited to, offering feedback to management related to process, working closely with provider development team to address provider issues, collaborating with financial team to improve efficiency and participates in training/mentorship initiatives.
- Is open to coaching and willing to find more efficient processes when applicable.
- No more than 5% variance based upon file count of incorrect service status (open vs. closed) during any audit of care coordinators files.
- Performs miscellaneous tasks and projects as assigned by management.
- To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- If working with federal government contract clients, an employee is required to receive federal government clearance for handling sensitive information. Employee is also required to receive annual security awareness training.
- Communicate well, oral and written, using proper grammar and etiquette.
- Effectively present information and respond to questions from internal and external customers.
- Write routine reports and correspondence.
- Understand financial concepts such as revenue, costs of goods sold, margin and mark-up.
- Apply concepts such as fractions, percentages, ratios, discounts and proportions to practical situations.
- Solve practical problems.
- Navigate a variety of concrete variables in situations where limited standardization exists.
- Interpret a variety of instructions furnished in written, oral, diagram, or scheduled form.
- To perform this job successfully, an individual should have intermediate skills in Microsoft Outlook; Microsoft Word; Microsoft Excel; Internet Explorer; internet software and database software.
- Certified Dental Assistant – Highly Preferred. Expanded Functions preferred.
- Tier II – 4-7 years dental experience that ranges from General to Specialty practices. A Tier II Coordinator is responsible for managing medium complexity files that require 5+ appointments from initiation to completion of treatment, and/or coordination across multiple specialties. These file types generally include treatment plans with multiple implants, non-complex TMJ files, and litigated files.
KNOWLEDGE, SKILLS AND OTHER ABILITIES:
- Problem solving skills
- Analytical skills
- Research skills
- Case management
- Customer service
- Interpersonal skills
- Multi-tasking skills
- Listening skills
- Communication skills
PHYSICAL/EMOTIONAL DEMANDS & WORK ENVIRONMENTS:
- For roles located in office or home settings; this job is primarily sedentary and may involve repetitive motions; the employee is regularly required to sit, use hands and fingers, speak, and hear
- For roles located in the field; this job is primarily active; the employee is regularly mobile and must be able to utilize transportation (such as driving), sit, use hands and fingers, speak, and hear
- The employee is occasionally required to stand, walk, and lift objects (up to 10 lbs. weight; up to 4 ft. height)
- Specific vision abilities required by this job include ability to see things from a close distance and ability to adjust focus
- The work environment utilizes florescent lighting; noise level is moderate
- The emotional demand of the job may cause undue stress from, but not limited to, moderate/heavy workload
- Reasonable accommodations will be individually assessed and possibly made to enable individuals with disabilities to perform the essential functions of the position
- Please be advised the job description is subject to change at any time
841 Prudential Dr, Suite 204
Jacksonville, FL, 32207