Dental Care Coordinator I

Company: One Call
Location: Jacksonville
Posted on: March 18, 2023

Job Description:

Dental Care Coordinator IWe're looking for colleagues who are ready to Think Big, Go Fast, Deliver Awe, and Win Together. These core values embody our diverse and inclusive culture and help us live out our mission of "getting people the care they need when they need it." Over the last 30 years, our company has established itself as the market leader in managed care for the workers' compensation industry. We are committed to making a positive impact in the lives of the injured workers we serve, and we have fun doing it.--Salary Range:--15.50 - 21.39 HourlyThis compensation range takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At One Call, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is 15.50 - 21.39 HourlyBenefits Summary:--In return for your commitment to our company's mission, we offer a vast array of benefits to help support the whole you.--

• Opportunities to work from home--
• Competitive wages with opportunities to earn annual merit increases--
• Paid development hours to use for professional and community development!--
• Generous paid time off, 8 company holidays, and 2 floating holidays per year--
• $1,000 Colleague Referral Program--
• Enterprise Recognition Program rewarding colleagues for their extraordinary work--
• Exclusive discounts on travel, activities, and merchandise via work discount program--
• Colleague Assistance Program that provides free counseling and financial services--
• Tuition Reimbursement Program including certifications--
• Quantum Health: A healthcare navigation platform to help our colleagues make the best, most cost-effective healthcare decisions--
• Medical, dental, and vision insurance--
• Pre-Tax FSA and HSA health savings accounts--
• 401(k) matching--
• Company paid life insurance--
• Company paid short term and long-term disability--
• Referral program
• Healthcare concierge--
• The One Call Foundation which aims to help colleagues during unexpected emergencies, from car accidents to natural disasters.----JOB SUMMARY:----Provides support to business by coordinating care to workers compensation patients via the telephone and/or Internet (e.g., instant message, email). Handles inquiries and resolves simple and basic issues, scheduling appointments, or managing visits; and responsible for ensuring treatment is appropriately planned and managed from initial treatment visit to treatment completion, and all customers are continuously updated and satisfied. Coordinates the dental treatment of assigned case files. For product or service-related issues, will move patient to appropriate department. Performs other administrative duties as requested.GENERAL DUTIES & RESPONSIBILITIES:--Customer Support: 80%--
  • Serves as primary contact for coordination of care and patient issues. Escalates more technical or medical-related issues to the proper department.--
  • Coordinates internal and external resources in order to ensure files move forward within established timeframes.----
  • Prioritizes daily activities in a manner that all assignments are completed. Reviews and responds to any requests from clients, provider, claimant, or supervisor and performs necessary action steps within 48 hrs.--
  • May take referrals from adjusters, case managers and sales representatives and forward to appropriate department for processing. *Care coordinators do not process referrals - managed by the Intake department.--
  • May process and resolve a high volume of patient inquiries about One Call products and services. --
    • Utilizes appropriate tracking tools, i.e., authorization logs, Outlook Calendar or Portal Task function, to ensure follow-up on critical timelines as outlined in One Call's Dental department's procedures for obtaining evaluations/notes, tracking authorizations, and contacting carriers. --
    • Tracks and documents inbound support requests and ensures proper notation of problems or issues. --
    • Enters new plans of treatment, requesting pricing and clinical review.----
    • Negotiates rates of reimbursement, as applicable. Coordinates any special payment arrangements for non-contracted providers. ----Critical Thinking: 10%--
      • Troubleshoots patient problems; identifies the root cause of the problem; and uses tool and resources appropriately to determine how to resolve problems. Contacts dental provider or adjuster to obtain authorization for additional or continued service(s). ----
      • When unable to resolve the problem in a reasonable amount of time, will escalate to the appropriate resource. Follows up on escalated issues with coaching and mentoring to learn the appropriate solution and expand overall knowledge. --
      • Engages in process improvement strategies by providing constructive feedback on processes, tools and resources.--
      • May be required to test new IT applications and/or functionality for technical enhancements to the Dental platform.----Administrative: 10%--
        • Requests all missing documentation such as notes, claims, state forms, authorizations and images for each appointment as necessary.--
        • Review all incoming documents for accuracy and legibility. Sends all supporting documentation and state forms to the customer.--
        • Accurately estimates treatment dates by line item based on the approved treatment plan, required healing time and all coordination between services to ensure accurate revenue forecasting.----EDUCATIONAL AND EXPERIENCE REQUIREMENTS:--
          • High school diploma/GED required.----
          • Certified Dental Assistant - highly preferred--
          • Expanded Functions preferred, or the equivalent combination of education, training, and work experience.--GENERAL KNOWLEDGE, SKILLS & ABILITIES:--
            • Excellent verbal and written communication skills.--
            • Excellent interpersonal and customer service skills.--
            • Excellent organizational skills and attention to detail.--
            • Excellent time management skills with a proven ability to meet deadlines.--
            • Strong analytical and problem-solving skills.--
              • Ability to function well in a high-paced and at times stressful environment.--
              • Proficient with Microsoft Office. To perform this job successfully, an individual should have intermediate skills in Microsoft Outlook; Microsoft Word; Microsoft Excel; Internet Explorer; internet software and database software.------PHYSICAL/EMOTIONAL DEMANDS & WORK ENVIRONMENT:--
                • For roles located in office or home settings; this job is primarily sedentary and may involve repetitive motions; the employee is regularly required to sit, use hands and fingers, speak, and hear.
                • 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.
                • --The employee is occasionally required to stand, walk, and lift objects (up to 10lbs weight; up to 4 ft. height).
                • --Specific vision abilities required by this job include ability to see things from a close distance and ability to adjust focus.
                • --The work environment utilizes florescent lighting; noise level is moderate.
                • --The emotional demand of the job may cause undue stress from, but not limited to, moderate/heavy workload.
                • --Reasonable accommodations will be individually assessed and possibly made to enable individuals with disabilities to perform the essential functions of the position
                • --Please be advised this job description is subject to change at any time.--

Keywords: One Call, Jacksonville , Dental Care Coordinator I, Healthcare , Jacksonville, Florida