What are the responsibilities and job description for the Dental Patient Authorization Specialist position at Tampa Family Health Centers?
Position Summary
The Dental Patient Authorization Specialist has the responsibility to oversee all patient treatment scheduling coordination by submitting and tracking preauthorization and referrals, bill and reconciled charges and any duties related to revenue cycle.
Essential Duties & Functions
• Guarantees all Tampa Family Health Center patients are treated with quality customer service.
• Bills and reconcile charges and any duties related to revenue cycle.
• Verifies insurance coverage, limitation and utilization, and coordinate referrals.
• Researches, corrects, and re-submits rejected and denied claims.
• Collects and/or updates all patient’s insurance or income information to bill patients or their insurance companies properly including arranging payment plans.
• Assists Social Worker to identify and address unmet needs and access to specialty care.
• Submits all Referrals and Preauthorization to the specialist and/or to the proper insurances
• Maintains tracking sheets that demonstrate evidence of compliance with assignments, routine referrals to be initiated within 10 working days; ASAP referrals initiated within 3 working days; urgent referrals to be initiated within 24 hours. Communication of referral status to dentist as appropriate, serves as a resource person to other staff regarding the referral process. Stays up to date on the changes in managed care policies as related to the processing of referrals and scheduling referral appointments timely.
• Calls for authorization for all insurance requiring prior “auth” or those assigned to other providers
• Identifies referrals to be schedule by other staff in accordance with the referral degree of difficulty
• Trains dental front specialist with all insurances aspect to assure proper collection of documents for billing, referrals and preauthorization follow up.
• Coordinates pre-visits identifying patients’ responsibilities and insurance coverage.
• Stores all patient records securely and handled in compliance with HIPAA and all TFHC, accreditation agency, State and Local rules and regulations.
• Guarantees all referrals are up to date.
• Support the Mission, Vision and Values of TFHC
• Perform all duties and tasks efficiently and effectively, as assigned by Director of Revenue Cycle
Required Education, Certifications, Licenses, & Training
• High school diploma or equivalent
Required Years of Experience
• Minimum (1) year academic training in an allied health related field. Two or more preferred
Required Knowledge, Skills, and/or Abilities
• Ability to navigate and enter data into an electronic health record
• Strong communication skills, both written and oral
• Excellent Computer Skills
• Outstanding customer service skills