[Hiring] Insurance Coordinator @Tufts University

Role Description

Under limited supervision, the Insurance Coordinator:

• Checks patient insurance eligibility, benefits, limitations and coverage.
• Obtains and tracks prior authorizations and follows up with insurances, patients and internal teams.
• Documents/updates accounts regarding coverage guidelines and limitations.
• Answers eligibility and benefit coverage inquiries.
• Ensures patients understand, consent and are compliantly notified, having signed and consented to treatment costs and notified regarding estimated financial responsibilities, such as deductibles, co-pays, co-insurance amounts and 100% financial responsibility for non-covered costs.
• Communicates with healthcare providers and insurances to ensure required standards and applicable laws are followed, upheld and compliantly met.
• Makes recommendations for resolutions and notifies/informs if/when laws and or standards are updated or changed.
• This position's role and responsibilities are deadline driven; requires accuracy and attention to detail.
• Plays an essential and key role in the Dental School's revenue cycle management, with a direct impact on the clinic's financial and billing outcomes success.
• Acts as a back-up to the billing team, assisting with answering phone calls.
• Performs billing administrative tasks and other billing related duties, assisting in timely and accurate revenue cycle management outcomes.

Qualifications

• High School degree/GED.
• 2 - 3 years of insurance benefits, eligibility and coverage experience.
• Must be customer service focused (internal and external), with excellent communication, attention to detail, organizational and interpersonal skills.
• Knowledge of 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 eligibility, benefits and coverage.
• Requires expert attention to detail and ability to effectively communicate technical information, aptitude and willingness to learn and drive change.
• Certified Dental Coder (CDC) within 1 year.

Requirements

• Bachelor's Degree (preferred).
• Experience coordinating benefits (preferred).
• Knowledge of Medicare and commercial insurance regulations, guidelines and applicable federal/state healthcare laws (preferred).
• Expert knowledge of axiUm software (preferred).
• Working knowledge of third-party billing (preferred).
• Certified Dental Coder (CDC) applicant with 4 - 6 years of medical/dental insurance verification or financial coordination experience in a fast-paced dental/medical healthcare setting (preferred).

Benefits

• Minimum $27.30, Midpoint $32.50, Maximum $37.70.
• Salary is based on related experience, expertise, and internal equity; generally, new hires can expect pay between the minimum and midpoint of the range.