Dental Benefits Coordinator

　　Tribal, 2 Kwaaypaay Court, El Cajon, California, United States of America Req #14006

　　Monday, January 22, 2024

　　The ancestors of the Sycuan Band of the Kumeyaay Nation existed many centuries ago as a community of people…a Tribe living together, farming, hunting and fishing to survive.

　　Much has changed since that time. Today the Sycuan Tribe governs its Reservation, owns and operates a Casino and a Golf Resort, and owns a number of other business ventures in the San Diego Region.

　　One attribute that remains unchanged, however, is Sycuan's sense of community. Sycuan is more than just a business. Sycuan is a community of people working together toward a common goal. Whether you work in our state-of-the-art Casino, our beautiful Resort, or become a staff member in our Tribal Government division, you will be part of the Sycuan family.

　　Job Purpose:

　　The purpose of the Dental Benefits Coordinator [DBC] is to primarily engage and assist patients in navigating the complex dental healthcare environment. The Dental Benefits Care coordinator is the primary liaison, coordinating and integrating patient related care insurance benefits with provider treatment plans [financial responsibility], assists in referral process, and is the patient portal specialist. The Dental Benefits Coordinator will improve the patient experience by reducing barriers for access to care that support quality-driven health outcomes, build clinic capacity and meet insurance-driven quality metrics.

　　Job Duties and Responsibilities:

　　(Note: Duties and responsibilities may be added, deleted or changed at the sole discretion of Sycuan management at any time)

　　Essential Functions of the Job:

　　Dental Benefits specialist:

　　Ensures complete and accurate new patient registration, including demographics and current insurance information

　　Reminds patients of a scheduled appointment

　　Serves as point person for the multidisciplinary evaluation process to include patient scheduling, third-party communications, and internal communications

　　Assembles information concerning patient's clinical background and referral needs and insurance benefits [including incentives for care]

　　Contacts insurance companies to ensure verification of benefits and prior authorization approval requirements are met.

　　Assists patients in problem-solving potential issues related to financial or social barriers (e.g., request interpreters as appropriate, transportation services, etc.)

　　Plans in advance to ensure tasks are complete and seek to add value to every work assignment.

　　Coordinates care within the guidelines of health plans, contracts, or insurance types.

　　Interacts with patients in person at clinic sites while demonstrating a high level of customer service and cultural competency.

　　Interfaces with patient and insurance company-related incentive programs

　　Referral Specialist:

　　Process outgoing medical records requests to SMDC patients medical release and other professional facilities, including attorneys, insurance companies, and government agencies

　　Ensures proper authorization has been obtained before records are released

　　Entry of all referral information into specialized reports and/or i2i modules. Documentation of all interventions to include date and time.

　　Documents necessary information pertaining to referral order in patient’s electronic health record

　　Submits and obtains authorizations to insurances, tracks the status of authorizations, and once approved, documents procedure approval number and authorization period in the referral tracking system

　　Obtains prior-authorization from insurances as related to the referral as needed

　　Provides excellent customer service by keeping patients updated on the status or completion of the referral

　　Provides follow-up to confirm if the patient was seen by an outside provider/facility and obtains consultation notes from the visit

　　Coordinates and monitors and reports correspondence from specialist

　　Provides basic health education, including health promotion and disease prevention (HP/DP) education

　　Works with primary care provider to work on re-processing authorization denials

　　Collaborates with all clinical staff to identify patients that may benefit from specific program enrollment due to patient conditions and/or needs

　　Send “trying to reach you” letters, recall letters, to patients when unable to contact by phone

　　Patient Portal Liaison:

　　Implements maintains, and responds to Patient Portal requestsApproaches patients in waiting areas or as directed by SMDC staff about the benefits of the SMDC Patient Portal. Assists patients and families to enroll in the SMDC Patient Portal (via email invitation or self-enrollment). Provides personalized tutorials showing new users how to navigate the Patient Portal, including downloading the SMDC Patient Portal app on patient’s smartphone, signing into the app, and teaching patients and families to use features of the Patient Portal (view labs, notes, message doctor, renew prescriptions, join video visit, etc.)

　　Educates staff on the SMDC Patient Portal processes and functionality through training and demonstrations.

　　Maintains strict confidentiality in compliance with HIPAA guidelines

　　Provides technical assistance to patients experiencing issues.

　　Records and reports a log of all patient interactions.

　　Communicate process failures with the program supervisor.

　　Meets with team lead weekly or bi-weekly to discuss program development and support.

　　Reports all technical issues experienced for examination and resolution to team chat and IT solutions when needed.

　　Passes along patient feedback, concerns, and opportunities for growth in the context of facility goals and initiatives.

　　May help with basic patient access functions (scheduling or health coverage issues).

　　Enters patient data [re. demographic information] into the clinic tracking system [NextGen or Dentrix]

　　Additional Duties and Responsibilities:

　　Enhances professional growth and development through participation in educational programs, current literature, in-service meetings, in-service training, and workshops, modeling a high-performance work ethic.

　　Performs other related duties as assigned or requested by Supervisor or Manager.

　　Treats all clients and staff, and the community with respect and courtesy

　　Utilizes effective means to resolve conflict

　　Utilize effective verbal and written communication skills

　　Participates in Continuous Quality Improvement CQI activities

　　Job Specifications:

　　Education and Experience:

　　Essential:

　　High school diploma or GED equivalent.

　　Current valid California driver's license, car insurance, and or proof of reliable transportation.

　　A minimum of 6 months experience in the dental healthcare setting.

　　Knowledge of programs and health plans eligibility and guidelines

　　Knowledge, experience in translation of patient’s dental insurance eligibility/co-pay profile to the treatment plans recommended by provider, to estimate patient insurance financial responsibilities.

　　Dental/Medical terminology and basic computer. Ability to handle multiple activities simultaneously. Be attentive to patient needs and concerns. Willing to work with others as a team member.

　　Desirable:

　　3 years in the dental healthcare setting, experience with referral process, prior authorizations, registration and scheduling of dental providers, Dental Assistant certification, experience with dental coding and data processing

　　Tribal clinic experience

　　Dental receptionist experience

　　Skills and knowledge:

　　Essential:

　　Through knowledge of dental office procedures

　　Proficiency in the use of electronically based dental practice management systems

　　Thorough knowledge of laws and regulations governing the management of dental records

　　Thorough knowledge of OSHA regulations pertaining to dental clinic operations

　　Ability to speak, read and write in English

　　Proficiency in the use of Microsoft Office Suite and web search browsers

　　Ability to type at least 30 words per minute

　　Ability to sit or stand for prolonged periods of time

　　Ability to lift up to 40lbs

　　Ability to perform repetitive bending, reaching, pulling and pushing movements

　　Ability to use various office machines

　　Ability to communicate and interact effectively with patients and staff

　　Ability to complete forms and documents

　　Ability to prioritize and perform multiple tasks

　　Ability to understand and follow oral and written instructions

　　Ability to maintain confidentiality

　　Ability to maintain a professional appearance and demeanor

　　Ability to adhere to SMDC work attendance and punctuality policies

　　Ability to accept constructive criticism

　　Desirable:

　　Understanding of Native American culture and customs

　　Bi-lingual

　　Proficiency in the Dentrix Dental Practice Management System/NextGen

　　Supervisory/Managerial Accountability:

　　Direct: None

　　Indirect: None

　　If you enjoy being part of a community dedicated to creating a memorable guest experience, we invite you to explore career opportunities with Sycuan and join our winning team!

　　Other details

　　Pay Type Hourly

　　Apply Now

　　Tribal, 2 Kwaaypaay Court, El Cajon, California, United States of America