This is a full-time position working M-F, 8am-4:30pm with a start pay of $22.19 per hour. Weekly Earned Wage Access is an option for this position.

Job Purpose or Objective(s): Responsible for reviewing and processing patient claims for services provided contracted dental providers. 

Primary Tasks:

Procure health services from private providers through written contracts and agreements within established policies and procedures.   Negotiate and award purchases of health services within delegated monetary authority parameters. Schedule approved dental services utilizing contracted vendors. Issues the Purchase Orders once it has been determined the claims can be attached to an approved referral or scheduled appointment for services provided at the contracted vendors.  Determines if the patient was to file for an alternate resource and ensures the documentation is in the RPMS system prior to issuing the purchase orders. Confirm patient eligibility regarding Indian Descent and residency requirements per Choctaw Referred Care guidelines. Enters information found on purchase orders and check numbers with date paid into the RPMS system. Notify the patient/families requesting copies of all bills for approved dates of services. Review claims to ensure the CPT code listed on the claim is payable by the CRC Department.  Re-price claims using the 3M pricer for contracted vendors or contracted rates. Mail out letters to the patient and vendors to request claims for approved services. Types letters, forms, reports, and other written materials in final form with responsibility for correct spelling, grammar, format, clarity and neatness. Performs other duties as may be assigned.

Required Education, Skills and Experience: 

MINIMUM

High School Diploma or GED Advanced understanding of insurance policies and procedures Good computer skills  Good communication skills Ability to multi-task and organize Excellent customer service Ability to work in a fast pace environment Ability to maintain strictest confidentiality and adhere to HIPAA guidelines/regulations 3 years’ directly related experience

TARGET

Associates degree in business or related field Advanced understanding of insurance policies and procedures Good computer skills  Good communication skills Ability to multi-task and organize Excellent customer service Ability to work in a fast pace environment Ability to maintain strictest confidentiality and adhere to HIPAA guidelines/regulations 3 years’ directly related experience