Dental Care Referrals Coordinator

Essential Job Responsibilities

Administrative Duties 

Processes specialty referrals for patient visits including in-house specialists and outside providers via insurance portals, phone calls etc.

Ensures proper and smooth operational flow as it relates to patient visit (i.e. prioritizes patient flow based on dental needs)

Records and maintains patient’s health records in agency’s database (i.e. NextGen, Provide Enterprise) as required

Coordinates appointments for patients with dental specialists.

Ensures proper and timely closing of tasks as it relates to referrals and open orders via EDR.

Ensures documentation is timely, accurate, legible and updated in the EDR.

Processes additional information requested by insurance companies for authorizations (i.e. medical records, documentation from providers, etc.

Assists in authorizations denials and appeals on behalf of the patient and documents outcomes in EDR.

Ensures external 3rd party documentation (i.e. labs, consultations report etc.) is collected and entered in the patient’s electronic dental records (EDR).

Responds to all correspondences and tasks (via letter, email, faxes) in a timely manner. 

Makes phone calls and documents in patient dental records per Dental Provider’s request.

Contacts patient for follow-up appointments, rescheduling and referred appointments.

Ensures proper patient identification using a minimum of two (2) patient identifiers as per national patient safety goals requirement.

Prepares and reviews next day’s patient schedule and staff & care requirements to maintain patient flow.

Assists with the completion of forms as needed.

Maintains effective communication with patients in reference to wait time, patient needs and expectations and patient feedback.

Completes all tasks sent on behalf of patients by the requested timeframe.

Ensures compliance with health center’s policies and procedures. 

Verifies patient insurance carrier/coverage to ensure proper processing of referrals.

Maintains control of specialist list and referrals.

Clinical Duties 

Reports referral status and/or treatment plan to the Dental Provider.

Reviews visit summary with patient upon discharge by Dental Provider.

Enters self-management goals and plan of care.

Provides accurate and timely documentation within the same day of intervention and enters other information as requested by Dental Provider.

Quality Assurance/Compliance

In conjunction with supervisor, ensures dental operations fully comply with agency and HIPAA, Joint Commission and Patient Centered Medical Home requirements.

Participates in site visit(s) as well as programmatic audits as required.

Ensures that on-line trainings are current as required (UltiPro and other trainings).

Culture of Service: 3 C’s

Compassion

• Greets internal or external customers (i.e. patient, client, staff, vendor) with courtesy, making eye contact, responding with a proper tone and nonverbal language.

• Communicates with internal or external customer (i.e. patient, client, staff, vendor) attentively, reassuring and understanding of the request and providing appropriate options or resolutions.

Competency

• Provides services required by following established protocols and when needed, procure additional help to answer questions to ensure appropriate services are delivered.

Commitment

• Takes initiative and anticipates internal or external customer needs by engaging them in the process and following up as needed.

• Prioritize internal or external customer (i.e. patient, client, staff, vendor) requests to ensure the prompt and effective response is provided.

Safety

Ensures proper handwashing according to the Centers for Disease Control and Prevention guidelines.

Understands and appropriately acts upon the assigned role in Emergency Code System.

Understands and performs assigned roles in the organization’s Continuity of Operations Plan (COOP).

Contact Responsibility

The responsibility for internal external contacts (i.e. deal with people in a respectful, sensitive and professional manner) is frequent and important

Physical Requirements

This work requires the following physical and sensory activities: constant talking in person, talking on the phone, hearing/ visual acuity and exposure to blood borne pathogens and hazardous materials. Frequent, walking, standing, sitting and bending. Work is performed in office setting. 

Other

Participates in health center developmental activities as requested.

Other duties as assigned.