PHELO Dental Insurance Specialist

Position Summary
Perform all insurance verifications and pre-determinations/pre-authorizations. Understands and assists patients with third
party billing systems. Reviews patient’s insurance breakdowns for accuracy. Understands and utilizes CDT codes. Works
closely with administrative and clinical staff. Build positive relationships with patients by efficiently, effectively, and
courteously communicating information.
Essential Functions
To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each
essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with
disabilities to perform the essential functions.
• Operate office equipment, such as voice mail messaging systems, and use word processing, label making software,
copier, printer and scanner.
• Communicates effectively, courteously, and professionally with patients, parents/legal guardians, and clinical and
administrative staff.
• Informs patient of their fiscal responsibilities with respect to their particular insurance coverage.
• Interview patients to complete documents such as insurance forms.
• Complete insurance verification forms. Contact patient regarding pre-authorization/pre-determination status.
• Understands and utilizes CDT codes.
• Position may be responsible for opening the office.
• Treats patients, visitors and co-workers with respect and courtesy.
• Proficiently uses conflict resolution and problem-solving techniques in managing interpersonal conflict and patient
complaints.
• Efficiently operates assigned computer software (i.e., Eaglesoft, and Microsoft Office Suite).
• Prepares and delivers reports on time.
• Ensures printed material and forms are up to date. Insurance verification forms are updated semi-annually.
• Create and follow up with Medicaid pre-authorizations and traditional insurance pre-determinations. Contact
patient for additional insurance information and/or additional documentation.
• Communicate patient concerns to Dental Office Manager or Doctor.
• Complies with: Dental Depot policies and procedures; OSHA policies, procedures, rules, and regulations, as well as
HIPAA policies.
• Schedule approved treatment.
• Position may be required to relocate to other Dental Depot clinics either permanently or on a short-term basis due
to office needs, on an as needed basis at the discretion of Management.
• This position may complete other Administrative and Maintenance tasks as assigned by Management.
• Maintain regular and reliable attendance
Skills & Abilities
Dental Depot – Dental Business Office Assistant – 1/2018
Education: High School Graduate or General Education Degree (GED): Required
Experience: No prior experience necessary.
Certifications & Licenses: None
Computer Skills: Efficiently operates assigned computer software and other equipment, including Eaglesoft
and Microsoft Office Suite.
Other Requirements: Must have a valid driver's license, proof of valid vehicle insurance and must have annual
Motor Vehicle Record Check, as a condition of employment if employee operates any
Company owned vehicles or drives their own personal vehicle for Company business
purposes.
Must have knowledge of CDT Codes and pass the bi-annual Dental Depot CDT codes test.
Position Qualifications
• Communication, Written - Ability to communicate in writing clearly and concisely.
• Ethical - Ability to demonstrate conduct conforming to a set of values and accepted standards.
• Customer Oriented - Ability to take care of the customers’ needs while following company procedures.
• Communication, Oral - Ability to communicate effectively with others using the spoken word.
• Research Skills - Ability to design and conduct a systematic, objective, and critical investigation.
• Organized - Possessing the trait of being organized or following a systematic method of performing a task.
• Detail Oriented - Ability to pay attention to the minute details of a project or task.
• Accuracy - Ability to perform work accurately and thoroughly.
• Friendly - Ability to exhibit a cheerful demeanor toward others.
• Honesty / Integrity - Ability to be truthful and be seen as credible in the workplace.
• Safety Awareness - Ability to identify and correct conditions that affect employee safety.
• Self-Motivated - Ability to be internally inspired to perform a task to the best of one’s ability using his or her own
drive or initiative.
• Time Management - Ability to utilize the available time to organize and complete work within given deadlines.
• Energetic - Ability to work at a sustained pace and produce quality work.
• Reliability - The trait of being dependable and trustworthy.
• Working Under Pres