Dental Benefits Coordinator

Position Summary

The Dental Benefit Coordinator plays a critical role in improving patient experience and supporting the financial health of the Dental Department. This position is responsible for timely and accurate processing of dental pre-estimates, prior authorizations, Health Safety Net verification, and sliding fee scale determinations. The coordinator serves as the primary liaison between patients, providers, insurance carriers, and internal teams to ensure financial clarity, compliance, and efficient scheduling of dental services.

This role requires strong attention to detail, excellent communication skills, and a solid understanding of dental insurance benefits, billing workflows, and patient financial agreements.

Key Responsibilities

Insurance and Financial Coordination

• Verify dental insurance eligibility, benefits, deductibles, and coverage status using appropriate portals and systems
• Process dental pre-estimates for commercial insurance and prior authorizations for MassHealth
• Verify Health Safety Net eligibility and determine applicable deductibles
• Qualify uninsured patients for the Health Center’s Sliding Fee Program
• Submit required documentation including dental codes, x-rays, narratives, and treatment plans to insurance carriers
• Track approvals, denials, and pending submissions, and follow up within required timeframes

Patient Financial Counseling

• Meet with patients to explain insurance benefits, estimated costs, and financial responsibility
• Prepare, review, and obtain signatures for dental contracts, waivers, and payment agreements
• Ensure patients understand payment requirements prior to scheduling procedures
• Document all financial obligations clearly in the patient chart and messaging system

Scheduling and Workflow Management

• Schedule approved dental procedures in coordination with providers
• Scrub dental schedules daily to ensure approvals, contracts, and payment requirements are met
• Communicate patient payment expectations to registration staff in advance of appointments
• Conduct reminder calls to patients regarding upcoming appointments and payment due at check-in

Documentation and Compliance

• Ensure all required consent forms, contracts, and waivers are completed and scanned into EPIC and Dentrix
• Maintain accurate logs tracking pre-estimates, prior authorizations, HSN cases, and sliding fee patients
• Adhere to all departmental workflows, scripts, and financial policies

Reporting and Performance Monitoring

• Produce weekly and daily reports on submission status, approvals, denials, and collections
• Track key performance indicators including schedule accuracy, approval turnaround, and point-of-service collections
• Provide status updates on treatment plans, specialty referrals, and outstanding cases
• Support revenue optimization efforts through accurate billing preparation and workflow compliance

Key Performance Indicators

• 95 percent patient satisfaction score
• 100 percent of scheduled appointments with signed contracts and approvals
• 95 percent schedule accuracy through daily scrubbing
• 100 percent collection of estimated patient responsibility at check-in
• Timely submission and follow-up of all pre-estimates, prior authorizations, HSN, and sliding fee cases

Required Skills and Qualifications

• High attention to detail and strong organizational skills
• Knowledge of dental insurance plans, billing processes, and benefit coordination
• Excellent verbal and written communication skills
• Ability to explain complex insurance and financial information to patients clearly
• Strong interpersonal skills to collaborate with providers, staff, and insurance carriers
• Proficiency with EPIC, Dentrix, Trizetto, MMIS, and dental insurance portals preferred

Accountability and Expectations

• Maintain punctual attendance and reliability
• Meet all submission, documentation, and reporting deadlines
• Ensure compliance with Health Center policies and insurance requirements
• Contribute to improved patient experience, reduced denials, and optimized revenue collection

Skills and Qualifications

• • Minimum requirement 5-10 years of experience as licensed dental assistant
  • Previous managerial experience of projects and/or staff preferred
  • Excellent oral and written communication skills
  • Demonstrated proficiency in DENTRIX/DEXIS software use
  • Knowledge of management of dental prior authorizations, pre-estimates, and denials
  • Knowledge of dental practice operations
  • Excellent interpersonal, verbal, and written communication skills
  • Ability to manage multiple tasks, work under pressure, and prioritize workload.
  • Strong organizational skills and attention to detail is essential.
  • Ability to establish and maintain effective working relationships with patients and team members

Competencies, Skills, and Attributes:

• • High School Diploma or GED
  • Certified Dental Assistant
  • Knowledge of dental coding and billing procedures
  • 5-10 years of experience in Dental Front Office environment

Physical Requirements

• Must be able to stand or sit for prolonged periods (50% of the time) ·
• Must be able to lift 10-25 pounds and load onto shelves.
• Visual acuity sufficient for frequent reading and computer use.

Salary : $20 - $31