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Dental Care Coordinator I in Jacksonville, FL at One Call

Date: 11/6/2018

Job Snapshot

Job Description


Dental Care Coordinator I


Time Off: 15 days of Paid Time plus 10 paid holidays in first year,

Benefits: Medical, Dental, Vision, 401(k), and Company-paid Short/Long Term Disability.

GENERAL DUTIES & RESPONSIBILITIES:

  • Schedules initial treatment appointment by calling the provider and claimant to schedule, faxing the provider authorization, and updating the client with the appointment information.
  • Updates the estimated To Be Scheduled (TBS) date by line Item for any unscheduled treatment (continuously updates and manages until the line item is scheduled).
  • Performs day prior, of, and after calls for each Date of Service (DOS) which includes phone calls to the provider and patient, and updates to the client.
  • Links and un-links treatment line items accurately in treatment appointments from the Plan of Treatment (POT).
  • Updates client again with the clinical status when clinical documentation is received from the provider.
  • Uses My SMILES Diary queues, ticklers, and notification features daily to efficiently manage the case load and keep the clients updated.
  • Enters new Plans of Treatment, requests pricing and clinical reviews. Once reviewed and priced, sends the authorization (with supporting documentation) to the client for approval and calls to explain the additional/change in treatment.
  • Handles any special payment arrangement with non-contracted providers including pre-pays and discounts/negotiations.
  • Responds to the financial team’s requests within 48 hours in an effort to process claims received.
  • Works all special reports distributed by a supervisor/manager.
  • Reviews and responds to any requests from clients, provider, claimant, or supervisor and performs necessary action steps within 48 hours.
  • Demonstrates a positive attitude consistently 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.
  • Demonstrates willingness and is open to coaching and willing to find more efficient processes when applicable.
  • Performs work accurately (no more than 5% variance based upon file count of incorrect service status (open vs. closed) during any audit of care coordinators files).
  • Performs miscellaneous tasks and projects as assigned by management.

EDUCATIONAL REQUIREMENTS:

  • Bachelor's degree (B. A. or B.S.) or two to four of years related experience and/or training; or equivalent combination of education and experience. Certified Dental Assistant Preferred.

GENERAL KNOWLEDGE, SKILLS & ABILITIES:

  • Problem solving skills.
  • Analytical skills.
  • Research skills.
  • Project management.
  • Customer service.
  • Interpersonal skills.
  • Confidentiality.
  • Listening skills.
  • Oral communication skills.
  • 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 calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference and volume.
  • Ability to apply concepts of basic algebra and geometry.
  • Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
  • Ability to interpret a variety of instructions furnished in written, oral, diagram, or scheduled form.
  • Knowledge of Microsoft Word; Microsoft Works; Microsoft Excel; Microsoft Internet Explorer; Smiles proprietary software; and Microsoft Outlook.

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