Insurance Coordinator

Insurance Coordinator

Primary Purpose:
Under the supervision of the Patient Financial Services Manager,
processes insurance claims and performs other related duties to
include auditing of patient charts, posting of insurance payments,
and collections referrals.

University of the Pacific recognizes that diversity, equity, and
inclusion is foundational to the success of our valued students and
employees. We prioritize policy and decision-making that
demonstrates awareness of, and responsiveness to, the ways
sociocultural forces related to race, gender, ability, sexuality,
socioeconomic status, etc. impede or propel students, faculty, and
staff.

Essential Functions:

• Perform daily audit of all patient health records to ensure
  financial accuracy and the presence
  of complete treatment documentation; initiate process of necessary
  corrections and
  communicate errors to the appropriate student, faculty, or staff
  member; request additional
  information and/or documentation as needed.
• Prepare and generate insurance claims for hard copy submission
  or batch electronic claims
  for electronic submission.
• Respond to requests from insurance companies for additional
  information and/or required
  documentation for pending claims; work with appropriate personnel
  to facilitate resolution.
• Post and allocate insurance payments timely and accurately
  based on explanation of benefits.
• Initiate refund requests to insurance companies due to
  incorrect processing of claims.
  Accurately process all financial recoups in a timely manner with
  thorough documentation.
• Generate and review accounts receivables reports; analyze
  information to determine
  appropriate financial write offs and adjustments, validity of
  insurance denial reasons, and
  patient financial responsibility; determine collectable balances
  and resolve appropriately;
  identify, audit, and refer delinquent accounts for
  collections.
• Review documentation and claims for accuracy in order to
  facilitate timely reimbursement of
  claims to include but not limited to private and government
  insurance programs, patient
  contracts, and special grant projects.
• Communicate insurance and policy requirement and regulations,
  reference materials
  and CDT updates to appropriate personnel; collaborate with internal
  and external clinics to
  establish constructive methods and procedures.
• Assist and provide guidance to students, residents, faculty,
  and staff regarding efficient and
  compliant CDT coding.
• Support processing needs of special grant programs and special
  discounts offered annually
  during mock boards.
• Perform all other duties as assigned by the Patient Financial
  Services Manager.

Minimum Qualifications:

Knowledge of:

• Advanced private dental/medical insurance billing or general
  accounting policies and
  procedures.
• Basic accounting/billing procedures.
• Intermediate level dental terminology and treatment
  planning.
• Electronic health records software.
• Basic knowledge of Microsoft Word, Excel and Outlook.

Experience:

• Minimum of two years insurance billing in a high-volume dental
  setting.

Education:

• High school diploma or equivalent.

Preferred Qualifications:

Ability to:

• Manage multiple job priorities and tasks efficiently,
  effectively and accurately while
  demonstrating close attention to detail.
• Communicate professionally and courteously with faculty,
  residents, students, patients and
  staff.
• Maintain confidentiality of materials and information.
• Research and/or resolve financial conflicts with insurance
  companies and patient accounts.
• Support and contribute to a positive and productive team
  environment.

Experience:

• Basic knowledge processing public dental insurance claims.
• Knowledge of medical terminology.

Education:

• Vocational or other training in the dental field highly
  desirable.

Other:

• Experience and sensitivity in working with people of diverse
  backgrounds and cultures.
• Demonstrated experience in advancing social justice, equity,
  and inclusion in a university
  setting.
• Ability to engage and integrate culturally responsive practices
  and knowledge in their work.

Physical Requirements:

The physical demands described here are representative but not
definitive of those that must be met by an employee to successfully
perform the essential functions of this job.

• Work performed is primarily general office/administrative with
  frequent use of computer
  keyboard, mouse, and telephone; requires sitting majority of the
  working day.
• Occasional reaching, bending, standing and walking.

Hiring Range: 34.26