Job Details

OMS Case & Program Coordinator-Oral Surgery Clinic
Go to our website »

Position Number: 6042245
Location: Chattanooga, TN
Position Type: Medicine - Other Medicine

OMS Case & Program Coordinator-Oral Surgery Clinic
Memphis, TN, United States

Job Identification: 1898
Job Category: Administrative
Posting Date: 02/28/2025
Job Schedule: Full Time
Locations: 875 Union Avenue, Memphis, TN, 38163, US (On-site)

Job Description
Market Range: 06

Hiring Salary: $20.00/Hourly

JOB SUMMARY/ESSENTIAL FUNCTIONS: The Oral and Maxillofacial Surgery Care and Program Coordinator supports insurance-related revenue functions and ensures compliant billing and collections procedures. This position acts as a subject matter expert related to medical and dental CDT coding and offers guidance and directives to residents, faculty, and staff by completing patient prior authorizations for medical and dental procedures that are performed in both the office and the hospital.

Responsibilities
DUTIES AND RESPONSIBILITIES:

Verifies patient insurance eligibility and benefits utilizing internet resources or manually procuring information from the insurance carrier; notifies providers of eligibility restrictions, patient financial obligations, and provides directives on the use of compliant CDT coding.
Maintains Commission of Dental Accreditation (CODA) accreditation data system and surveys for the program, collecting and evaluating information from various sources throughout the campus.
Manages the operations of the residency program to include budgeting, auditing, procurement, marketing, resident benefits, compliance, and accreditation activities.
Conveys information regarding procedure codes and diagnostic codes to receive correct referrals for office visits and authorizations for inpatient and outpatient hospital procedures.
Performs daily audits on patient health records to ensure financial and coding accuracy including the presence of complete and compliant chart documentation; initiates corrections and communicates errors to providers and staff; requests additional information or documentation as needed; monitors and notifies providers of missing charges.
Proactively resolves payment issues by anticipating and identifying problems and coordinating appropriate solutions before claim submission; corrects fees on accounts as needed before claim submission; responds to payor requests for additional information for pending claims.
Generates, researches, analyzes, and resolves aged insurance balances.
Communicate processes with patients seeking reimbursement and support efforts in an effective and timely manner.
Documents and credentials all graduate medical education training conducted within the department; maintain all resident personnel record.
Plans, organizes, and schedules graduate residency interviews
Prepares and generates insurance claims and pre-authorizations for electronic and hard copy submission; monitors unsubmitted claims.
Maintains industry expertise in CDT coding and compliance as well as insurance regulations and billing procedures.
Performs other duties as assigned.

Qualifications
MINIMUM REQUIREMENTS:

EDUCATION: High School Diploma or GED. (TRANSCRIPT REQUIRED)

EXPERIENCE: Four (4) years of public and private medical/dental claims processing; OR Bachelor's Degree in lieu of experience.

KNOWLEDGE, SKILLS, ABILITIES:

Knowledge of private medical/dental insurance billing policies.
Expert knowledge of medical/dental terminology, treatment planning, and CDT coding.
Knowledge of accounts receivable and collections processes.
Ability to manage multiple job priorities and tasks efficiently, effectively, and accurately while demonstrating close attention to detail.
Ability to communicate professionally and courteously with faculty, residents, students, patients, and staff.
Ability to identify, research, and/or resolve financial conflicts with insurance companies and patient accounts.
Ability to support and contribute to a positive and productive team environment.

WORK SCHEDULE: This position may occasionally be required to work weekends.

About Us

To apply, visit https://fa-ewlq-saasfaprod1.fa.ocs.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_1/job/1898/?mode=location