Express Scripts Prior Authorization Jobs in North Carolina

Title: Dental Patient Representative I

Department: Operations

Status: Non-Exempt

Position Classification/Category: Clerical

Level: N/A

Location: Assigned Clinic

Hourly Pay Range:

Reports To: Dental Operations Manager  

Direct Reports: N/A

Summary of Position

Under the direct supervision of the Dental Operations Manager, this position is responsible for timely and accurate recording of patient demographics, insurance information, patient charges and payments. The Dental Patient Representative facilitates patient entry into Cabarrus Rowan Community Health Centers (CRCHC), including greeting client, answering phone calls, and scheduling appointments.

Minimum Qualifications

Ability to read, write and comprehend the English language.  Communicates effectively. Must be able to sit and stand for long periods of time.  Ability to effectively maintain confidentiality of records and communicate with all levels of personnel.

·         Experience: One year or less of clerical experience in an office setting

• Additional skills required: Requires excellent organizational, problem solving and critical thinking skills. Strong basic computer skills required. Able to maintain confidentiality and work collaboratively in a team environment.   
• Additional skills preferred: Bilingual in Spanish and English

Education: High school diploma or GED. Associates Degree preferred.

Certification(s)/Licensure: N/A

Physical Requirements:

The physical demands described here represent those that must be met by an employee to successfully perform the essential functions of this job.

·         Repetitive movement of hands and fingers – typing and/or writing.

·         Occasional standing, walking, stooping, kneeling or crouching.

·         Reach with hands and arms.

·         Talk and hear.

Key Responsibilities

1.       Demonstrate the ability to express the high-quality level of customer service to all patients, staff, board members, providers, and vendors.

2.       Can verbalize knowledge of chain of command and direct supervisor information.

3.       Reports on time and checks schedule and organizes patient flow.

4.       Demonstrates ability to obtain payment information and ability to create claim to be submitted for reimbursement.

5.       Can verbalize knowledge of required screening forms for UDS and other QI.

6.       Maintains accurate documentation and registration updates in EMR based on documentation procedures.

7.       Demonstrate ability to adhere to scheduling protocol as it relates to scheduling of all CRCHC appointment types (including medical, behavioral health, psych, dental, ambulatory procedures)

8.       Demonstrate ability to adhere to clinical protocol to assist patient with appointments and re-routing patient to triage as necessary.

9.       Under adequate supervision, demonstrates ability to explain the sliding scale program to all patients and accurately process the program application.

10.    Under adequate supervision, demonstrates the ability to compose messages to provider/staff regarding patient communication.

11.    Demonstrates accurate knowledge and comprehension of patient registration duties not limited to medical, dental, referral information, and insurance verification information.

12.    Demonstrates accurate ability to enter patient registration information into EMR system.

13.    Complete Dental requests for all CRCHC locations in terms of prior authorizations and referrals.

14.    Review patient chart for records requiring updating and perform necessary updates.

15.    Verbalizes knowledge of HIPAA, patient demographic, and benefits information.

16.    Maintains a safe, secure, and healthy work environment by following and enforcing established policies and procedures while providing compassionate care to patients.

17.    Maintains patient confidentiality and protects operations by keeping protected health information confidential and secure.

18.    Participates in mandatory in-services and drills, attend staff meetings and other training courses, including appropriate educational training offered on regular basis for professional development.

19.    Maintains strict adherence to infection control guidelines established by the organization.

20.    Work early /night clinic and weekends as needed.

21.    Ability to travel to other CRCHC to cover as needed.

22.    Perform other duties as assigned.