Special Authorization Analyst at MAC Dental handling requests for dental services in response to clients and providers. Full-time position requiring bilingual skills and dental knowledge.
Responsibilities
Develop a high level of knowledge in the programs we administer.
Respond to requests from clients and providers in both official languages.
Receive, pend, and process requests for dental services that require special authorization consideration, and prepare packages that require review from dental consultant.
Administer processes for special authorization decisions through the interactive use of telecommunications and applied on-line technology.
Call and/or draft requests for additional information from dentist and/or dental specialists for more information/diagnostics when necessary, or requested by the dental consultant.
Update requests according to decisions rendered to allow for real time adjudication when the dental treatment authorized is rendered.
Create and send the appropriate decision letter to the client and/or provider to notify them of the outcome of their request.
Utilize dental background, knowledge, and experience to assess requests.
Liaison with customers and other health care professionals to ensure treatment requests are appropriately administered.
Provide a positive and efficient customer service experience for providers and clients.
Requirements
Successful completion of a recognized post-secondary Dental Assisting or Dental Hygiene program.
Minimum of 24 months experience in a dental environment.
Experience working in an office and/or customer service experience would be considered an asset.
Experience with quick and accurate data entry and knowledge of claims processing, eligibility and claims systems would be considered an asset.
Experience working with the Microsoft Office Suite.
Must be fluently Bilingual (English and French) both written and verbal.
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