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Care Coordinator I - Dental Staffing in Jacksonville, FL at One Call

Date: 9/25/2018

Job Snapshot

Job Description

Care Coordinator I - Dental Staffing - Tampa

Staffs files weekly by accessing the Preferred Provider Network and out-of-network providers, if necessary.

GENERAL DUTIES & RESPONSIBILITIES:

  • Selects and schedules new and pending files with the appropriate dental provider.
  • Takes new referrals as they are called in for both doctor and dental files quickly and efficiently. Enters referral into proprietary software, SMILES.
  • Obtains previous dental records from provider's office or insurance carrier.
  • Sends appropriate provider packet prior to scheduled appointment.
  • Obtains payor authorization for new evaluations.
  • Requests billing information from provider and ensures proper codes are utilized.
  • Communicates expectations effectively with provider until evaluation is scheduled. Communicates with Nurse Case Manager/Adjuster daily until evaluation is scheduled.
  • Works with non-contracted providers to coordinate and schedule appointments when contracted providers are not available.
  • Explains applicable state forms to provider office.
  • Follows up on all assigned files daily.
  • Demonstrates a positive attitude consistently, dependability and an overall commitment to excellence and is a team player.
  • Participates in continuous operational improvements actively. Specific activities include, but are not limited to, offering feedback to management related to process, working closely with provider development team to address provider issues, collaborating with financial team to improve efficiency and participates in training/mentorship initiatives.
  • Maintains willingness to learn new things and is open to coaching and willing to find more efficient processes when applicable.
  • Performs miscellaneous tasks and projects as assigned by management.
  • Completes other duties as may be assigned by management.

EDUCATIONAL REQUIREMENTS:

  • Associate’s Degree (A.A. or A.S.) or one (1) to two (2) years related experience and/or training; or equivalent combination of education and experience. Expanded Functions Dental Assistant License Preferred.

GENERAL KNOWLEDGE, SKILLS & ABILITIES:

  • Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.
  • Ability to write routine reports and correspondence.
  • Ability to speak effectively before groups of customers or employees of organization.
  • Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
  • Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
  • Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
  • Ability to deal with problems involving several concrete variables in standardized situations.
  • Knowledge of Microsoft Office (Word, Works, Excel; Internet Explorer and Outlook) and Smiles proprietary software.
  • Performs other duties as assigned.

PHYSICAL/EMOTIONAL DEMANDS & WORK ENVIRONMENTS:

  • For roles located in office or home settings; this job is primarily sedentary and may involve repetitive motions; the employee is regularly required to sit, use hands and fingers, speak, and hear.
  • For roles located in the field; this job is primarily active; the employee is regularly mobile and must be able to utilize transportation (such as driving), sit, use hands and fingers, speak, and hear.
  • The employee is occasionally required to stand, walk, and lift objects (up to 10 lbs. weight; up to 4 ft. height).
  • Specific vision abilities required by this job include ability to see things from a close distance and ability to adjust focus.
  • The work environment utilizes florescent lighting; noise level is moderate.
  • The emotional demand of the job may cause undue stress from, but not limited to, moderate/heavy workload.
  • Reasonable accommodations will be individually assessed and possibly made to enable individuals with disabilities to perform the essential functions of the position.
  • Please be advised the job description is subject to change at any time.


Care Coordinator I

 

Entry-level role. Basic skills with moderate level of proficiency. Generally performs a high volume of basic inquiries about One Call’s products and services by following standard scripts and procedures. Works under close supervision without latitude for independent judgment. Consults with senior peers and team leads on non-complex issues to learn through experience. Typically requires zero to one year of experience in a call center or customer service-related position in a service industry. Zero- 2 years of experience in the workers compensation industry. Care Coordinator I’s will handle one service line or more and will become knowledgeable in these areas before moving into a level II role.

EEO Employer


841 Prudential Dr, Suite 204
Jacksonville, Florida, 32207
United States ​