Dental Coder and Treatment Plan Coordinator

APLA Health’s mission is to achieve health care equity and promote well-being for the LGBT and other underserved communities and people living with and affected by HIV. We are a nonprofit, federally qualified health center serving more than 14,000 people annually. We provide 20 different services from 15 locations throughout Los Angeles County, including: medical, dental, and behavioral health care; PrEP counseling and management; health education and HIV prevention; and STD screening and treatment. For people living with HIV, we offer housing support; benefits counseling; home health care; and the Vance North Necessities of Life Program food pantries; among several other critically needed services. Additionally, we are leaders in advocating for policy and legislation that positively impacts the LGBT and HIV communities, provide capacity-building assistance to health departments across the country, and conduct community-based research on issues affecting the communities we serve. For more information, please visit us at aplahealth.org.

We offer great benefits, competitive pay, and great working environment!

We offer:

Medical Insurance

Dental Insurance (no cost for employee)

Vision Insurance (no cost for employee)

Long Term Disability

Group Term Life and AD&D Insurance

Employee Assistance Program

Flexible Spending Accounts

11 Paid Holidays

4 Personal Days

10 Vacation Days

12 Sick Days

Metro reimbursement or free parking

Employer Matched 403b Retirement Plan

This is a great opportunity to make a difference!

This position will pay $26.20 - $31.39 hourly. Salary is commensurate with experience.

POSITION SUMMARY:

This position is under the direction of the Dental Director, Clinic Director, and Dental Operations Manager. The Dental Coder and Treatment Plan Coordinator is responsible for ensuring all encounters have correct information prior to being sent for billing. This is a daily function and applies to the multiple dental offices. The position also requires oversight on patients' treatment plans and referrals.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Registration information

o Ensure all patient registration information is collected and properly scanned. Review accounts and train front office staff if necessary on registration requirements.

o Provider telephone or in-person new patient registration to ensure all paperwork is appropriately completed.

Insurance Verification

o Oversee that medi-cal or insurances are reviewed, confirmed, and documented.

o Provide documentation that insurances are checked for patients reporting no coverage.

o For uninsured patients that may be eligible for insurance, oversee the referral to the enrollment staff.

Sliding Fee Application and Income Verification -

o Manage and review all Sliding Fee Application

o Coordinate with the enrollment team for patients who participate in other APLA Health & Wellness departments.

o Discuss and confirm with patients their understanding of the Sliding Fee Application and potential fees associated with dental services.

Appointment Workflow

o Review all appointment visits and confirm cases are correctly attached properly.

o Oversee the front office staff attachment of cases and ensure these are correctly added prior to the provider locking the progress note.

o Confirm appropriate billing notes are attached and added properly.

CPT and ICD coding

o Review the CPT and ICD-10 coding from Dental Examination Module, Progress note, and on the patient encounters within 24-48 hours of visit.

o Understand what different insurances will cover and what is an uncovered benefit. This may be based on the code itself, the diagnosis for the treatment, or the timing on when the code is used.

Treatment Planning Review

o Coordinate any fees and costs with patients associated with treatment plans.

Referral Process

o Complete DHSP specialty referrals and provide timely follow-up with patients.

Prosthodontic Scheduling

o Review actions and requirements and justifications.

o Confirm justification approval prior to scheduling

External Lab Invoices and Communication

o Assemble and review all external lab invoices. Communicate with the labs on outstanding invoices and payments. Review and submit payment requests to the fiscal department.

Liaison to Billing and Fiscal Departments -

o Establish open communications with the fiscal and billing department. Answer any questions they have on codes and dental related billing challenges. Provide feedback and timely responses as needed.

Medical Records –

o Complete and document ROI requests and subpoenas. Communicate with the Compliance Department on records releases and proper process to document the release of information.

Support

o Support oversight with Dental Director and Dental Operations Manager. Provide all dental staff the support that is required to operate the dental clinic.

OTHER DUTIES MAY BE ASSIGNED TO MEET BUSINESS NEEDS.

REQUIREMENTS:

Training and Experience:

AA Degree and 3 years in the administrative side of a clinical practice OR High school diploma/GED and 3 years of dental billing experience.

Applied knowledge of ADA procedures and codes

Knowledge of the principles and practice of modern dentistry

Experience working with multiple benefits coverage programs, including private insurance and government programs

Experience working in a Federally Qualified Health Center preferred

Bilingual English/Spanish preferred

Knowledge of:

Advanced computer skills including the Microsoft Office suite

Clinic/health care operations management

HIV disease, and other health disparities and comorbidities

HIPAA and OSHA guidelines

eClinicalWorks or similar electronic health record system

Managed care eligibility and authorization process

Dental terminology; current ICD and CPT coding

Healthcare billing processes and insurance plans (Medicaid, Medicare, and private/commercial plans; dental preferred)

WORKING CONDITIONS/PHYSICAL REQUIREMENTS:

This is primarily an office position that requires only occasional bending, reaching, stooping, lifting and moving of office materials weighing 25 pounds or less. The position requires daily use of a personal computer and requires entering, viewing, and revising text and graphics on the computer terminal and on paper.

SPECIAL REQUIREMENTS:

Must possess a valid California driver’s license; proof of auto liability insurance; and have the use of a personal vehicle for work related purposes.

COVID vaccination and booster required or medical/religious exemption.

Equal Opportunity Employer: minority/female/transgender/disability/veteran.

TO APPLY:

Visit our website at www.aplahealth.org to apply or click the link below:

https://www.paycomonline.net/v4/ats/web.php/jobs/ViewJobDetails?job=139176&clientkey=A5559163F67395E0A2585D2135F98806