Dental Care Referrals Coordinator

Position Overview:

BLS certification required

High school diploma required

Job Summary

The Dental Care Referrals Coordinator supports the department by providing direct patient care. They will be responsible for the coordination of all dental referrals as it pertains to specialty care and will ensure timely follow-up with specialty dental referrals for patients.

Essential Job Responsibilities

Administrative Duties

Process specialty referrals for patient visits including in-house specialist and outside providers via insurance portals, phone calls etc.

Ensure proper and smooth operational flow as it relates to patient visits (i.e. prioritizes patient flow based on dental needs)

Record and maintain patient health records in agency's database (i.e. NextGen, Provide Enterprise) as required

Coordinate appointments for patients with dental specialist.

Ensure proper and timely closing of task as it relates to referrals and open orders via EDR.

Ensure documentation is timely, accurate, legible and updated in the EDR.

Process additional information requested by insurance companies for authorizations (i.e. medical records, documentation from providers, etc.

Assist in authorization denials and appeals on behalf of the patient and document outcomes in EDR.

Ensure external 3rd party documentation (i.e. labs, consultations report etc.) is collected and entered in the patient's electronic dental records (EDR).

Respond to all correspondence and task (via letter, email, faxes) in a timely manner.

Make phone calls and document in patient dental records per Dental Providers request.

Contact patients for follow-up appointments, rescheduling and referred appointments.

Ensure proper patient identification using a minimum of two (2) patient identifiers as per national patient safety goal requirements.

Prepare and review next day patient schedules and staff & care requirements to maintain patient flow.

Assist with the completion of forms as needed.

Maintain effective communication with patients in reference to wait time, patient needs, expectations and patient feedback.

Complete all task sent on behalf of patients by the requested timeframe.

Ensure compliance with health centers policies and procedures.

Verify patient insurance carrier/coverage to ensure proper processing of referrals.

Maintain control of specialist list and referrals

Clinical Duties

Report referral status and/or treatment plan to the Dental Provider.

Review visit summary with patient upon discharge by Dental Provider.

Enter self-management goals and plan of care.

Provide accurate and timely documentation within the same day of intervention and enter other information as requested by Dental Provider.

Quality Assurance/Compliance

In conjunction with supervisor, ensure dental operations fully comply with agency and HIPAA, Joint Commission and Patient Centered Medical Home requirements.

Participate in site visit(s) as well as programmatic audits as required.

Ensure that on-line trainings are current as required (UltiPro and other trainings).

Safety

Ensure proper handwashing according to the Centers for Disease Control and Prevention guidelines.

Understand and appropriately acts upon the assigned role in Emergency Code System.

Understand and perform assigned roles in the organization's Continuity of Operations Plan (COOP).

Culture of Service: 3 C's

Compassion

Greet internal or external customers (i.e. patient, client, staff, vendor) with courtesy, making eye contact, responding with a proper tone and nonverbal language.

Communicate with internal or external customer (i.e. patient, client, staff, vendor) attentively, reassuring and understanding of the request and providing appropriate options or resolutions.

Competency

Provide services required by following established protocols and when needed, procure additional help to answer questions to ensure appropriate services are delivered

Commitment

Take initiative and anticipates internal or external customer needs by engaging them in the process and following up as needed

Prioritize internal or external customer (i.e. patient, client, staff, vendor) requests to ensure the prompt and effective response is provided

Contact Responsibility

The responsibility for internal external contacts (i.e. deal with people in a respectful, sensitive and professional manner) is frequent and important

Physical Requirements

This work requires the following physical and sensory activities: constant talking in person, talking on the phone, hearing/ visual acuity and exposure to blood borne pathogens and hazardous materials. Frequent, walking, standing, sitting and bending. Work is performed in office.

Other

Participate in health center developmental activities as requested.

Other duties as assigned.

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