The Dental Coordinator will obtain and retrieves existing medical notes and reports by calling Home Health Care and MRI providers. Verifying existing record; scans and properly archives records in the computer systems. Delivering records via email and or fax to workers’ compensation adjusters and nurse case managers.
Job Title: Dental Coordinator
Reports to: Area Director of Operations
- Associates Degree from two-year college or university; or one to two years’ related experience and/or training; or equivalent combination of education and experience.
- Expanded Functions Dental Assistant (EFDA) License Preferred but not required.
- Other Considerations (i.e. amount of travel required, position location):
- Business meetings, conferences, seminars
- As approved by Department Director
Program selling and rate negotiation:
- Locating the appropriate dental provider needed based on the injury reported and gaining agreement from the provider’s office to accept a Workers’ Compensation dental injury referral.
- Negotiation of provider reimbursement at the point of scheduling to ensure the provider does not expect 100% payment of billed charges.
- Securing a Single Case Agreement (SCA) or verbal agreement of detailing negotiated rates.
- Select and schedule new and pending files with the appropriate dental provider.
- Obtain needed provider demographics such as correct spelling of the provider’s name as it appears on their license, NPI, License #, etc.
- Obtain previous dental records from provider’s office or insurance carrier, and ensures previous records are submitted to new evaluating providers.
- Sends appropriate provider packet prior to scheduled appointment.
- Ensures payer authorization has been received prior to the scheduled evaluation.
- 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.
- Explains applicable state forms to provider office, as applicable.
- Follows up on all assigned files daily.
- Schedules all assigned files within 72 hours from the date of intake referral.
- Discusses any files with internal teams to determine next steps and the best course of action as needed
- Ability to speak effectively to all MTI customers including the payer, injured worker and provider.
- Ability to read, interpret and educate providers on contract language, provider manuals, and delegated agreements.
- Excellent oral (phone and in-person) and written communications with the ability to sell providers on the value proposition of our organization and educating them on our policies and processes.
- Ability to communicate with internal teams to achieve common goals in a team-oriented manner.
- Basic math functions including addition, subtraction, multiplication, division, rates, ratios and percentages.
- Understanding of provider fee schedules, UCR, Usual and Customary (U&C) •Understanding of basic accounting (i.e., Receivables, Payables, Profit Margin, etc.)
Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Individuals may need to sit or stand as needed. May require walking primarily on a level surface for periodic periods throughout the day. Reaching above shoulder heights, below the waist or Lifting as required to file documents or store materials throughout the work day. Proper lifting techniques required. May include lifting to 3 pounds for files, computer printouts on occasion.
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.
Auditory/Visual: Hearing, vision, and talking. Specific vision abilities required by this job include ability see things from a close distance and ability to adjust focus
Work Environment: Utilizes fluorescent lighting; noise level is moderate. For the most part ambient room temperatures, lighting and traditional office equipment as found in a typical office
The Job Description is subject to change at any time
MTI is an Equal Opportunity Employer
By submitting a resume for this position, you authorize MTI to contact you via phone, email, or text message to coordinate an interview.