Insurance Coordinator - Berwyn

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Overview:

The Insurance Coordinator is responsible for the ongoing documentation requirements of new and existing patients’ insurance benefits verification to ensure accurate treatment estimates.

Responsibilities:

• Liaise with insurance providers to elucidate patients' coverage and to resolve disputes about rejected claims
• Prioritizes and processes incoming Insurance Verifications, Referrals, and Prior Authorization requests
• Verifies member/patient eligibility
• Ensures insurance carrier documentation requirements are met
• Understands and can explain dental and medical insurance plan benefits.
• Effectively communicate with others, including physician offices, insurance companies, patients, and others about insurance benefits and costs associated to procedures.
• Handles multiple assignments or pieces of work at one time. The capability of working within a stressful environment under consistent deadlines, pressures and interruptions.

Please note that additional responsibilities may be assigned.

Qualifications:

QUALIFICATIONS:

To perform this job successfully an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

EDUCATION:

High school diploma or equivalent

EXPERIENCE:

Knowledge of dental/medical benefits and breakdowns a plus

Proficient computer skills

COMPETENCIES:

To perform the job satisfactorily, an individual should demonstrate the following competencies:

• Technical Skills – Assesses own strength and weaknesses; pursues training development opportunities; strives to continuously build knowledge and skills; shares expertise with others
• Customer Service – Manages difficult or emotional customer situations; responds promptly to customer needs; solicits customer feedback to improve service; responds to requests for service and assistance; meets commitments
• Interpersonal Skills – Maintains confidentiality; listens to others without interrupting; keeps emotions under control; remains open to others’ ideas and tries new things
• Oral Communications – Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions
• Written Communication – Writes clearly and informatively; able to read and interpret written information
• Quality Management – Looks for ways to improve and promote quality; demonstrates accuracy and thoroughness
• Diversity – Shows respect and sensitivity for cultural differences; promotes a harassment-free environment
• Ethics – Treats people with respect; keeps commitments; inspires the trust of others; works with integrity and ethically; upholds organizational values
• Organizational Support – Follows policies and procedures; completes administrative tasks correctly and on time; supports organization’s goals and values; respects diversity
• Planning/Organizing – Prioritizes and plans work activities; uses time efficiently
• Professionalism – Approaches others in a tactful manner; reacts well under pressure; treats others with respect and consideration regardless of their status or position; accepts responsibility for own actions; follows through on commitments
• Quality – Demonstrates accuracy and thoroughness; monitors own work to ensure quality
• Safety and Security – Observes safety and security procedures; reports potentially unsafe conditions; uses equipment and materials properly
• Adaptability – Adapts to changes in the work environment; manages competing demands; changes approach or method to best fit the situation; able to deal with frequent change, delays, or unexpected events
• Attendance/Punctuality – Is consistently at work on time; ensures work responsibilities are covered when absent; arrives at meetings and appointments on time
• Dependability – Follows instructions, responds to management direction; takes responsibility for own actions; keeps commitments; commits to long hours of work when necessary to reach goals; completes tasks on time or notifies appropriate person with an alternate plan