About this role
Market Range: 06 Hiring Salary: $19.67/Hourly THIS POSITION IS LOCATED IN KINGSPORT, TN JOB SUMMARY/ESSENTIAL JOB FUNCTIONS: The Dental Claims Coordinator for the oversees all dental insurance billing, claims processing, and provider credentialing for Kingsport Dental Clinic. This position ensures accurate, timely claims and pre-authorizations, with a strong focus on services commonly required by patients with special health care needs such as hospital-based dentistry, sedation, and multidisciplinary treatment. This position serves as the clinic’s subject matter expert on CDT coding, payer requirements, and documentation standards for insurance
DUTIES AND RESPONSIBILITIES:
• Prepares and submits insurance claims and pre-authorizations (electronic and paper); monitors all unsubmitted or denied claims. • Identifies and resolves payment issues proactively, coordinating with payers to obtain claim approvals. • Audits patient records for accurate financial and CDT coding documentation; initiates corrections and communicates with providers to ensure compliant submissions. • Collaborates with the hospital to create a streamlined process (create and monitor PAs, insurance coordination, and hospital coordination). • Assists students, residents, and staff in understanding insurance protocols. • Maintain up-to-date knowledge of CDT coding, Medicaid/Medicare rules, and payer regulations for dentistry. • Explains treatment costs and insurance coverage. • Performs other duties as assigned.
EDUCATION: High School Diploma or GED. (TRANSCRIPT REQUIRED) EXPERIENCE: Four (4) years of public and private dental claims processing; OR Associate’s Degree and two (2) years of public and private dental claims processing. KNOWLEDGE, SKILLS, AND ABILITIES:
• Ability to organize and prioritize work to meet competing deadlines.
• Knowledge of special needs patient population guidelines, regulations, policy, and procedures
• Knowledge of public and private dental insurance billing policies.
• Ability to manage multiple job priorities and tasks efficiently, effectively, and accurately while demonstrating close attention to detail.
• Expert knowledge of dental terminology, treatment planning, CDT coding, accounts receivable and collections processes.
• Ability to communicate professionally and courteously with faculty, residents, students, patients and staff.
• Ability to identify, research and/or resolve financial conflicts with insurance companies and patient accounts.