Tufts University School of Dental Medicine (TUSDM) offers one of the most forward-looking educational environments in dental medicine in the country. The Medical and Dental Billing team, along with other members of the Finance and Administration team, supports the financial management and administration of the dental school. This position reports directly to the Billing Manager and works closely with school clinics it supports: Clinic Billing Operations, Dental Faculty Practice, Craniofacial Pain and Sleep Center, Oral Medicine, Oral and Maxillofacial Pathology and Tufts Dental Facilities.
Clinic Billing Operations (CBO) supports patient care services billing for the Pre-doctoral, Postgraduate and Specialty clinical treatment areas of the School, as well as any needed billing support for IRB clinical study patients and maintaining CITI certification. The Postgraduate Clinics (residents) are the Specialty Clinics, which includes: Endodontics, Orthodontics, Periodontics, Prosthodontics, Pedodontics, Oral and Maxillofacial Surgery, AEGD and Geriatric Dentistry.
What You'll Do
Under limited supervision, Clinic Billing Operation’s Patient Financial Coordinator relies on front end’s timely and accurate entry of patient demographics, insurance information and self-pay financial/collection aspects to support, enhance and help secure frontend collections. This position’s role and responsibilities are deadline driven and requires accuracy and attention to detail. The Patient Financial Coordinator is responsible for ensuring that scheduled and planned treatment meets insurance eligibility, benefits, limitations and coverage guidelines; obtaining and tracking all requested, necessary and/or required pre-treatment forms; following up with insurances, residents, patients and internal teams; documenting/updating accounts and ensuring patients accept, sign and fully understand their financial responsibilities. Answers eligibility and benefit coverage inquiries; communicates with residents, frontend, healthcare providers and insurances to ensure required standards are met and compliant and when applicable, makes recommendations for resolutions. Playing a vital role in the Dental School’s revenue cycle management, the Patient Financial Coordinator has a direct impact on the clinic’s financial and billing outcomes success.
What We're Looking For
Minimum Required Experience, Education, Background, And Certifications/Licenses
Bachelor’s Degree/Associate’s Degree preferred or High School degree/GED and 3+ years of proven compliant dental/medical healthcare financial, treatment planning or billing coordination, with insurance benefits, eligibility, limitations and guidelines. Must have exceptional EQ (emotional intelligence) and be customer service focused (internal and external), with excellent communication, attention to detail, organizational and interpersonal skills. Knowledge of pre-claims requirements for dental/medical insurances, insurance processes, billing/healthcare compliance and insurance guidelines, rules, regulations and requirements. Working knowledge of prior authorizations, insurance verification, including accurate and timely communication to internal team members and patients regarding financial responsibilities based on eligibility, benefits and coverage. Requires expert attention to detail and experience coordinating benefits. Needs to be driven, Excel knowledge, innovative, independent, self-starter, a leader, team player, analytical intelligence, exceptional attention to detail, ability to effectively communicate technical information, adaptable with an aptitude and willingness to learn and drive change. Dental coder certification (CDC) required, or within 1 year of hire date.
Additional Preferred Experience, Education, etc.
Bachelor’s Degree preferred. Certified Dental Coder (CDC) applicant with 4 - 6 years of dental/medical insurance verification and/or financial coordination experience in a fast-paced dental/medical healthcare setting. Expert knowledge of Medicare, MassHealth and commercial insurance pre-claims requirements, regulations and guidelines. Expert knowledge axiUm software. Familiarity with ADA codes, CPT Codes and ICD-10 Codes. Experience in a fast-paced dental/medical setting. Knowledge axiUm software.
An employee in this position must complete all appropriate background checks at the time of hire, promotion, or transfer.
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