Insurance Coordinator

Title: Insurance Coordinator - PRN
Practice: Greater Montana Oral & Dental Implant Surgery
Location: 60 Village Loop, Kalispell, MT 59901

Hours: Monday–Thursday: 9:00 a.m. – 5:00 p.m.; Friday: 9:00 a.m. – 3:00 p.m.
This is an as-needed position and not a guaranteed full-time role. The individual in this role will assist with day-to-day scheduling support and provide coverage during PTO and other staffing needs. Weekly hours will vary based on operational needs, and some weeks may offer up to 40 hours.

Position Purpose:

An insurance coordinator plays a critical role within our oral surgery practices. The Insurance Coordinator is responsible for overseeing and managing all insurance-related activities within the organization. This includes processing claims, verifying insurance coverage, handling patient or client inquiries, and ensuring compliance with relevant regulations. The role requires strong communication skills, attention to detail, and the ability to work effectively with various stakeholders, including patients, insurance companies, and healthcare providers.

Essential Functions

Insurance Verification and Authorization:

• Verify patient insurance coverage and benefits.
• Obtain pre-authorizations and referrals for services as required by insurance providers.
• Ensure that all necessary documentation is completed accurately and submitted in a timely manner.

Claims Processing:

• Prepare and submit insurance claims for reimbursement.
• Monitor and follow up on the status of submitted claims.
• Resolve any issues or discrepancies related to insurance claims and payments.
• Process patient refunds, as applicable.

Patient Communication:

• Answer patient calls and inquiries related to their insurance benefits and billing needs.
• Communicate with patients regarding their insurance coverage and financial responsibilities.
• Address and resolve patient inquiries and concerns related to insurance matters.

Billing and Reconciliation:

• Assist in billing processes and ensure accurate coding and billing for services rendered.
• Reconcile insurance payments and patient accounts.
• Identify and rectify billing errors or discrepancies.

Compliance and Record Keeping:

• Maintain up-to-date knowledge of insurance regulations and compliance requirements.
• Ensure that all activities comply with relevant laws, regulations, and organizational policies.
• Maintain accurate and organized records of insurance transactions and communications.

Collaboration and Coordination:

• Work closely with healthcare providers, billing departments, and insurance companies.
• Coordinate with other departments to streamline insurance processes and improve efficiency.
• Participate in team meetings and contribute to process improvement initiatives.

Qualifications

Education:

• High school diploma or equivalency, required.

• Certification in medical billing and coding or a related area is a plus.

Experience :

• Previous experience in insurance coordination, medical billing, or a related field is highly desirable.
• Familiarity with healthcare insurance policies, procedures, and regulations.
• Knowledge of relevant regulations and compliance requirements in healthcare.

Performance Requirements:

• Approachable, professional demeanor
• Strong communication and interpersonal skills.
• Detail-oriented and thorough in task execution.
• Excellent organizational and multitasking abilities.
• Proficiency in using relevant software and systems for claims processing and record keeping.
• Knowledge of medical terminology and healthcare practices.
• Ability to work in a fast-paced environment and handle stressful situations with professionalism.
• Empathetic and patient-focused approach to care coordination.
• Independent decision-making skills and utilization of sound judgement.

• We offer Medical, Dental, and Vision Insurance plans to our full-time employees.
• Two out of the three medical plans offered include Health Savings Account (HSA) eligibility.
• Company-paid Life, AD&D and Long-Term Disability coverage.
• Additional Voluntary Life and AD&D Insurance for you and your family!
• Voluntary Short-Term Disability Insurance available to you as well
• Dependent Care Flexible Spending Account (FSA) offered.
• Immediately begin saving for retirement through our 401(k) starting with very first paycheck!
• Employer 401(k) contribution and Profit Sharing after six months of employment
• PTO and 8 Paid holidays for fulltime employees!

DISCLAIMER

The above statements are intended to describe the general nature and level of the work being performed by people assigned to this work.  This is not an exhaustive list of all duties and responsibilities.  OPS’s management reserves the right to amend and change responsibilities to meet business and organizational needs as necessary.