This position is responsible to screen all patients for insurance eligibility and determine what services are covered under the patient’s insurance plan.
Determines patient financial status insured or uninsured and verifies insurance eligibility and coverage limitations.
Discuss provider recommended treatment plan with patient and collect patient signature if agreed. Determines if any out of pocket payment is required and collects payment from the patient prior to service being performed. Where applicable, completes, reviews and explains Advance Beneficiary Notice (ABN) with clients at each appointment.
Makes available payment plans for those patients who have difficulty paying in full and ensure patients sign financial payment plan agreement. Manages the payment and treatment plans and provides monthly report on pending treatment plans and payment plans.
Reviews future appointment schedules and conducts insurance verifications. Communicates with patients and updates system with client payment responsibility. Informs patient of insurance changes and expected payment amounts prior to visit.
Reviews patient ledger to determine outstanding balances and discuss payment plan options to get account in good standing.
Takes appropriate action to reassure individuals who are upset to reduce their tension by using diplomacy and effective conflict resolution skills; demonstrates sensitivity to the needs of applicants and co-workers by applying appropriate interpersonal communication skills.
Enlists applicants’ cooperation in providing verification of financial resources through use of sensitivity and tact.
Takes telephone calls from clients.
Acts as a liaison between applicants and other social service providers.
Assists the applicant in accurately completing the application for services; completes appropriate referral forms and applications to assist persons applying for other assistance.
Establishes and maintains excellent customer relations (both internal and external) by use of effective listening techniques, ascertaining the customer’s desires and objectives; anticipating customer needs; properly explaining requirements; and, giving high priority to customer satisfaction.
Requests and/or disseminates information, both verbally and in writing, to applicants, providers, employers, internal staff and local community agencies; independently generates appropriate, well-written, and grammatically correct correspondence.
Prioritizes and manages processing of caseload by estimating, scheduling, tracking of time and activities, and initiating appropriate follow-up actions to meet productivity and cycle-time standards. Monitors case files until approval or denial of application is established. Reports all client encounters on log sheets.
Meets or exceeds individual productivity metrics, quality and timeliness standards as defined by department guidelines.
Instructs clients on procedures and policies; informs clients of programs available to assist in payment of medical or dental bills.
Maintains self-motivation and independence in daily job performance with minimum supervision. Recommends ways to improve processes and business practices.
Represents the Health Care District in a highly professional manner projecting a positive impression in all client and health care provider contacts. Develops and maintains collaborative relationships with outside agencies responsible for providing verification of data.
Coordinates client services with caseworkers, County social workers, or other appropriate assisting agencies.
May provide interpreting services in a liaison capacity for the purpose of expediting access, assessment, and making the eligibility determinations or making referrals to other agencies for services.
Assists with the training of new employees, when necessary.
Performs dental assistant job duties as needed and required to maintain dental assistant licensing /credentials.
This job description reflects the general duties considered necessary to describe the principal functions of the job as identified and shall not be considered as a complete description of all the work requirements and expectations that may be inherent in the position. The omission of specific statements of duties does not exclude them from the position. Management of the Health Care District of Palm Beach County reserves the right to assign duties not listed herein as necessary to accomplish the goals of the organization.
High school diploma or G.E.D required. Training from an accredited Dental Assisting Program and expanded duties training certification preferred.
Three (3) to five (5) years previous experience or training that provides excellent knowledge of eligibility criteria for alternative government supported health care programs and benefits including Medicare, Medicaid, Social Security Disability CHAMPUS, Veteran’s Administration benefits, etc., and the ability to perform advanced administrative support functions required. Experience in dental registration or dental assisting preferred.
Valid Florida driver’s license required.
Multi-lingual ability (Spanish and Creole) strongly preferred.