Insurance Coordinator

This is a Full-Time Insurance Coordinator role.

This role will be hybrid and worked from our Waltham Home Offce.

42 North Dental is a leading dental support organization (DSO) focused on providing quality dentistry through our partnership with practices and empowering employees to provide exceptional patient care. 42 North Dental is headquartered in New England and is rapidly growing with over 100 practices across Connecticut, Indiana, Maine, Massachusetts, Michigan, New Hampshire, New Jersey, New York, Pennsylvania.

Our organization is currently seeking an Insurance Specialist. The Insurance Specialist is a key strategic and operational role responsible for activities related to Insurance Plan creation, Insurance eligibility management, and responding to practice requests regarding Insurance questions or related to patient benefits. This position will act as a subject matter expert for the practice teams to utilize when they have questions about their patient’s Insurance Plans. The ideal candidate will understand the importance of correct insurance plan setup and how that impacts the practice’s treatment planning and collection efforts.

• Review practice requests for creation of new Insurance Carriers in the Ascend PMS and determine if they are warranted.
• Create new Insurance Plans and set up coverage tables in the Dentrix Ascend system.
• Understand which payor fee schedule should be assigned to the Insurance Plan and attach it to the plan in Dentrix Ascend.
• Load and maintain insurance fee schedules in the Dentrix Ascend system.
• Support Insurance Plan cleanup efforts, as required.
• Support insurance verification efforts through reviewing new features offered by our vendor, auditing the practice team’s utilization of the eligibility tool, working with the training team to ensure the practices understand how to check patient eligibility, and answering questions as they arise.
• Ensure the compliance of practice teams to complete the full patient benefit form and that data they are sending appears to be reasonable to the payor.
• Manage all Help Desk tickets regarding insurance carriers, insurance plans, patient benefit questions, and responding to practice outreach.
• Support team members in assigned project-based work regarding insurance carriers, coverage, and patient benefits.
• Participate in team meetings and contribute to ongoing process improvements.
• Perform other related duties as assigned.

• High School Diploma or equivalent
• College Degree and/or equivalent experience preferred
• 1 year of experience working with dental or medical insurance and/or claims
• Medical or dental experience preferred