Dental Coordinator

Summary

Under the direction of the Dental Manager, the Dental Coordinator is responsible for coordinating all aspects of dental treatment plans, including incomplete plans, referrals, and prior authorizations. This role includes supporting all dental services, ensuring efficient communication, record‑keeping, inventory control, and high‑quality patient care. The Dental Coordinator will also assist in identifying issues with processes and help develop processes to ensure timely patient care and manage both internal and external referrals and prior authorizations.

• Communication:
  Conveys information accurately and efficiently. Written communication is direct, concise, and easy to understand. Ability to speak clearly and concisely.
• Decision‑making:
  Gathers necessary information to make good and timely decisions. Uses sound judgment and instincts.
• Directing others/Delegation:
  Assesses other staff member abilities and provides coaching and recognition.
• Planning/Priority setting:
  Organizes tasks and objectives in order of importance, timing, and predicted results. Works within measurable goals and outcomes.
• Problem solving:
  Works systematically to solve problems. Develops reasonable and timely resolutions. Ability to make suggestions on workflow or systems.
• Initiative:
  Takes prompt action to accomplish objectives. Seeks to resolve problems without being asked.

• Coordinate all aspects of incomplete treatment plans in a timely manner to ensure patients receive the care they need.
• Verify insurance coverage and obtain prior authorizations for services as required by individual insurance plans.
• Coordinate with the billing department and/or dental clinical staff as needed on prior authorizations, handle denied authorizations, and ensure proper management of claims.
• Ensure task box is managed efficiently, answering questions from support center staff regarding dental patients.
• Communicate information and updates to patients and providers.
• Document care coordination, telephone calls, and other relevant clinical information in EHR.
• Assemble paperwork and requested medical information and submit to specialty offices as needed for referrals or other patient coordination efforts.
• Ensure specialists accept the patient’s insurance plan.
• Establish and maintain professional relationships with all staff, providing excellent customer service.
• Inform leadership of concerns, backlogs, or insurance issues.
• Correspond with dental staff to ensure effective communication and scheduling.
• Plan and manage the infection control plan to meet OSHA, CDC, and ADA standards.
• Support and assist with special community outreach care programs.
• Prepare and mail follow‑up correspondence to parents or patients.
• Call/correspond with parents to schedule students/patients with healthcare needs for office or telehealth visits.
• Assist providers in ensuring all patient records and documents are accurately completed and filed.
• Maintain patient confidentiality at all times.
• If credentials allow, provide clinical coverage as needed to fill temporary gaps in staffing.

• Document in the patient’s record the referral to specialty services, including the date of referral, name of the provider, and scheduled appointment date.
• Track dental specialty referrals using the Grace Health Referral Tracking process.
• Monitor the performance of specialty providers, ensuring quality care and removing any provider who does not meet standards.
• Establish formal or informal referral agreements with specialists.
• Manage referral agreements with specialists in more remote locations if local specialists are unavailable.

• Monitor treatment plans for services that require prior authorization, and initiate PA process according to Standard Operating Procedure (SOP).
• Work PA by collaborating with dental clinical and billing staff to (re) submit the required information.
• Communicate with patients and staff as necessary to move through the PA process and ensure the patient receives the treatment they need.
• Monitor in‑progress PA requests to ensure timely documentation and follow up.

• Assist with coordination…