Dental Referral Coordinator - California Based
Johnson Service Group
Johnson Service Group (JSG) is seeking a Dental Referral Coordinator in California for a HealthPlan organization.
This position is remote but Must live in California.
Work Schedule: Monday- Friday, 8am-5pm (no weekends)
Pay rate range: $26.50-$33.50 DOE General Description: This role handles dental referrals, authorizations, network access, and provider relations. Key duties include matching members to suitable dental providers, managing dental network activities, and offering support to the Care Coordination, Customer Support, Claims, and Provider Services teams. Education and Experience: Bachelor’s degree in business administration, health care administration, social sciences, or related field. One (1) to three (3) years’ experience in a clinical or health care setting. Skills: Intermediate verbal and written communication skills. Intermediate proficiency in personal computers and in Microsoft Office Suite applications, including Outlook, Word, Excel, Teams, and PowerPoint. Intermediate meeting management and facilitation skills. Duties & Responsibilities: Referral Processing Receive and process referral requests and authorizations from members, primary care dentists, medical providers, and company departments. Review referral information and ensure that all necessary information is provided. Facilitate referral requests and authorizations. Provide member referrals. Monitor the referral queue volume daily and implement defined escalation process as needed. Network Support Maintain rapport and relationships with the network to support workflows and timely referrals and appointment scheduling. Serve as a subject matter expert on dental health benefits and dental provider network access. Collaborate with members, providers, and company departments to improve the referral process. Support and facilitate provider recruitment, contracting and onboarding; assists in recruitment of specialty providers. Onboard dental provider staff to company policies and procedures. Tracking & Reporting Maintain and update resources in dental coding terminology, documented workflows, and provider lists and availability. Track and report general and specialty provider access; identify, analyze and escalate emerging barriers and trends to Dental Benefits Manager. Assist in resolving elevated claims related provider issues, authorizations, and eligibility. Secondary Functions Adhere to work performance norms and attendance expectations. Perform other duties as assigned. JSG offers medical, dental, vision, life insurance options, short-term disability, 401(k), weekly pay, and more. Johnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law. #D800
This position is remote but Must live in California.
Work Schedule: Monday- Friday, 8am-5pm (no weekends)
Pay rate range: $26.50-$33.50 DOE General Description: This role handles dental referrals, authorizations, network access, and provider relations. Key duties include matching members to suitable dental providers, managing dental network activities, and offering support to the Care Coordination, Customer Support, Claims, and Provider Services teams. Education and Experience: Bachelor’s degree in business administration, health care administration, social sciences, or related field. One (1) to three (3) years’ experience in a clinical or health care setting. Skills: Intermediate verbal and written communication skills. Intermediate proficiency in personal computers and in Microsoft Office Suite applications, including Outlook, Word, Excel, Teams, and PowerPoint. Intermediate meeting management and facilitation skills. Duties & Responsibilities: Referral Processing Receive and process referral requests and authorizations from members, primary care dentists, medical providers, and company departments. Review referral information and ensure that all necessary information is provided. Facilitate referral requests and authorizations. Provide member referrals. Monitor the referral queue volume daily and implement defined escalation process as needed. Network Support Maintain rapport and relationships with the network to support workflows and timely referrals and appointment scheduling. Serve as a subject matter expert on dental health benefits and dental provider network access. Collaborate with members, providers, and company departments to improve the referral process. Support and facilitate provider recruitment, contracting and onboarding; assists in recruitment of specialty providers. Onboard dental provider staff to company policies and procedures. Tracking & Reporting Maintain and update resources in dental coding terminology, documented workflows, and provider lists and availability. Track and report general and specialty provider access; identify, analyze and escalate emerging barriers and trends to Dental Benefits Manager. Assist in resolving elevated claims related provider issues, authorizations, and eligibility. Secondary Functions Adhere to work performance norms and attendance expectations. Perform other duties as assigned. JSG offers medical, dental, vision, life insurance options, short-term disability, 401(k), weekly pay, and more. Johnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law. #D800
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