Temp/Casual Dental Prior Authorization Specialist

Objective/Overview:
CUHCC's mission is to seek health equity in our community by advancing the well-being of diverse people. The clinic is known for providing high quality care to diverse patients and is moving forward in improving timely access to care for patients. This position will be a goal-oriented, revenue-driven, highly accurate and motivated Dental Prior Authorization Specialist. Primary duties include, but are not limited to: Managing the complete dental prior authorization process in a timely and efficient manner and communicating with dental staff about progress and information needed, hence establishing and maintaining a strong relationship with providers, clients, patients, and fellow staff.

Essential Functions:
Managing Dental Prior Authorization. (90%)

• Working knowledge of Dental PA rules and requirements.
• Understanding of Government program guidelines on Dental claims and rules.
• Working with providers to verify requirements for PA submission, accessing necessary information , including X Rays , to complete the PA submission successfully.
• Prepare and submit completed PA to relevant insurances.
• Timely follow up on PA denials, exceptions or exclusions.
• Monitor each submission and respond timely with added information if required.
• Provide the Dental department with timely status updates of submissions.
• Inform Dental staff when PA is approved so that the necessary appointments can be scheduled
• Inform Dental staff about the conditions of the PA (if any) and also report the amounts available .
• Regularly meet with Dental manager and staff to discuss progress, problems experienced and how to change the process to solve those.
• Attend staff meetings when required.
• Perform additional duties as requested by the Manager or Management team.
  

Other duties as assigned. (10%)

Required Qualifications:

• High school diploma/GED and four years of general accounts transaction experience. Training may be substituted for some of the years of experience.
• Two years of healthcare claims reimbursement experience which must include a minimum of:
  (A) Two years of customer service
  (B) Two years of processing claims for a health-care entity
  (C) One year in electronic claim adjudications,
  (D) Two years of computer experience in a professional working environment.
• Demonstrated proficiency in working with computerized billing software, Microsoft Word, Microsoft Excel and other programs.
• Experience in doing dental prior authorizations and proficient in managing that workflow efficiently and accurately to ensure maximum entitled reimbursement.
  
  **A negative TB test is required for this position.

Required Skills:

• Attention to detail and persistence in completing tasks.
• Perform to company standards of compliance with policies and procedures.
• Ability to multi-task, organize tasks and prioritize.
• High-level oral and written communications skills to work with patients, staff, providers, and insurance companies.
• Excellent customer service skills.
• Willingness to work with patients and staff from diverse cultures, languages, and backgrounds.
• Capacity to work on a team and make positive contributions to the team.
• Indepth knowledge of the KEPRO platform.
• Knowledge of Dental treatment plan and authorizations.
  

Preferred Qualifications:

• Aptitude and/or interest in working with Medical, Dental, and Behavioral Health patients, providers, clinic staff, and insurance companies on the phone in a billing office setting and/or in person within a clinic setting.
• Wisdom software experience.
• Minimum of 40 wpm typing speed and 10-key by touch.
• Fluency in one of CUHCC's predominant patient languages (Spanish, Somali, Vietnamese, Lao, Hmong)
• Experience working in a community clinic

CUHCC serves nearly 11,000 patients a year through over 55,000 visits annually. The patient population comes from over 12 different racial and ethnic groups that span five continents. CUHCC's mission is to seek health equity in our community by advancing the well-being of diverse people. Candidates must be able to adapt behaviors to others' styles; interact with people who have different values, cultures, or backgrounds; be of service to difficult people; optimize the benefits of having a diverse workforce.

Teamwork is an essential skill to promote synergy within the organization. Candidates must be able to share due credit with coworkers; display enthusiasm and promote a friendly group working environment; work closely with other departments as necessary; support group decisions and solicit opinions from coworkers; display team spirit.

Candidates must have excellent communication skills and be able to clearly present information through the spoken or written word; read and interpret complex information; talk with customers or clients; listen well.

Staff is expected to demonstrate a high level of service delivery; do what is necessary to ensure customer satisfaction; deal with service failures and prioritize customer needs.

Pay Range: Between $33/hr - $37/hr; depending on education/qualifications/experience.

Retirement plan options are available for Civil Service, Faculty, Labor-Represented, Professional & Administrative, and Temp Casual classifications. Learn more about retirement plans.

Applications must be submitted online. To be considered for this position, please click the Apply button and follow the instructions. You will be given the opportunity to complete an online application for the position and attach a cover letter and resume.

Additional documents may be attached after application by accessing your "My Job Applications" page and uploading documents in the "My Cover Letters and Attachments" section.

To request an accommodation during the application process, please e-mail employ@umn.edu or call (612) 624-8647.

The University recognizes and values the importance of diversity and inclusion in enriching the employment experience of its employees and in supporting the academic mission. The University is committed to attracting and retaining employees with varying identities and backgrounds.

The University of Minnesota provides equal access to and opportunity in its programs, facilities, and employment without regard to race, color, creed, religion, national origin, gender, age, marital status, disability, public assistance status, veteran status, sexual orientation, gender identity, or gender expression. To learn more about diversity at the U: http://diversity.umn.edu

Any offer of employment is contingent upon the successful completion of a background check. Our presumption is that prospective employees are eligible to work here. Criminal convictions do not automatically disqualify finalists from employment.

The University of Minnesota, Twin Cities (UMTC)

The University of Minnesota, Twin Cities (UMTC), is among the largest public research universities in the country, offering undergraduate, graduate, and professional students a multitude of opportunities for study and research. Located at the heart of one of the nation's most vibrant, diverse metropolitan communities, students on the campuses in Minneapolis and St. Paul benefit from extensive partnerships with world-renowned health centers, international corporations, government agencies, and arts, nonprofit, and public service organizations.

At the University of Minnesota, we are proud to be recognized by the Star Tribune as a Top Workplace for 2021, as well as by Forbes as Best Employers for Women and one of America's Best Employers (2015, 2018, 2019, 2023), Best Employer for Diversity (2019, 2020), Best Employer for New Grads (2018, 2019), and Best Employer by State (2019, 2022).