Patient Services Coordinator II

BASIC FUNCTION
The Patient Clinical Coordinator II independently coordinates the daily administrative operations of an assigned HUCD clinic, module, or specialty area. The PCC II manages complex scheduling and patient-flow issues, performs advanced insurance and documentation review, conducts assigned claim follow-up and rebilling, supports treatment-plan coordination, monitors operational compliance, resolves escalated patient-access concerns, and supports accurate charge capture and clinic reconciliation. The position applies established policy with judgment and serves as a resource to PCC I staff, students, and clinical teams.

SUPERVISORY ACCOUNTABILITY
The PCC II has no formal supervisory responsibility unless specifically assigned. The position regularly provides functional guidance, workflow direction, training, and quality feedback to PCC I staff, temporary employees, and student workers and may coordinate desk coverage in the supervisor's absence.

NATURE AND SCOPE
Work requires independent prioritization, interpretation of established procedures, and frequent coordination with faculty, students, clinical leadership, the Business Office, Revenue and Data Management, insurers, and outside healthcare partners. The PCC II manages assigned insurance accounts and treatment-planning activities, resolves nonroutine operational and claim issues, and escalates complex denials, policy exceptions, high-risk compliance matters, and matters exceeding delegated financial authority.

PRINCIPAL ACCOUNTABILITIES
Clinic Operations and Patient Flow

• Coordinates daily operations of an assigned clinic, module, or specialty area, including patient routing, provider/student assignments, desk coverage, and follow-through on incomplete activity.
• Monitors schedules, chair utilization, cancellations, and bottlenecks; makes permitted same-day adjustments and recommends workflow improvements.
• Coordinates complex, urgent, and multidisciplinary appointments within established clinical and sequencing requirements.

Advanced Scheduling and Patient Coordination

• Reviews appointment requests for readiness, required referrals, authorizations, records, and treatment sequence before scheduling.
• Researches and resolves scheduling discrepancies and communicates coordinated next steps to patients and care teams.
• Manages escalated access and service concerns and documents resolution or referral to leadership.
• Documentation, Insurance, and Compliance Review
• Audits assigned records for missing signatures, consents, clinical documentation, appointment notes, and required supporting information; tracks deficiencies to resolution.
• Performs insurance eligibility and benefit review and initiates, submits, or tracks routine preauthorization requests using approved workflows.
• Maintains assigned insurance work queues, payer portals, follow-up logs, and supporting documentation.
• Monitors adherence to HIPAA, payer, University, and clinic requirements and reports recurring or significant variances.

Claims, Rebilling, and Revenue Cycle Support

• Reviews daily clinic activity for charge capture, completion status, provider/student attribution, and consistency between sign-in records and AxiUm.
• Follows up on assigned unpaid, rejected, or returned claims; obtains claim status and documents payer responses and required next actions.
• Corrects nonclinical claim errors and resubmits or rebills claims with required attachments and information in accordance with payer and University procedures.
• Assists faculty and students with correction of routine billing-completion issues without altering clinical documentation or making unauthorized coding decisions.
• Identifies denials, underpayments, coordination-of-benefits issues, and payer trends requiring escalation to the Billing Specialist, PCC III, or management.
• Reconciles daily batches, researches variances, and submits complete documentation to Revenue Control.

Treatment Planning Support

• Reviews treatment plans for required signatures, sequencing, insurance estimates, authorizations, and supporting documentation before treatment begins.
• Explains approved treatment estimates, insurance limitations, patient responsibility, and standard financial policies within delegated authority.
• Coordinates routine financial clearances and payment-plan documentation using approved terms and refers exceptions or complex cases to the PCC III or management.
• Tracks patient follow-up and treatment-plan readiness and communicates outstanding requirements to patients, students, faculty, and the Business Office.
• Training, Quality, and Service
• Trains and coaches PCC I staff and student workers on approved procedures, systems, customer service, and documentation standards.
• Compiles routine operational data and identifies trends involving no-shows, incomplete documentation, unposted activity, patient wait times, and workflow barriers.
• Participates in process-improvement initiatives and supports implementation of revised procedures.
• Performs other related duties as assigned.

CORE COMPETENCIES

• Thorough working knowledge of dental terminology, common CDT codes, payer requirements, claim forms, scheduling, registration, and revenue-cycle processes.
• Proficiency with axiUm or a comparable dental practice-management system and ability to research claim and account discrepancies across reports and patient records.
• Ability to interpret explanations of benefits, claim status, benefit limitations, preauthorization requirements, and standard treatment estimates.
• Ability to coordinate complex workflows, interpret policy, prioritize independently, and exercise sound judgment.
• Ability to de-escalate patient concerns and communicate expectations firmly, clearly, and respectfully.
• Ability to train others, conduct operational audits, document findings, and recommend corrective action.
• Strong mathematical, reconciliation, analytical, organizational, and written communication skills.

MINIMUM REQUIREMENTS
Associate degree and four (4) years of progressively responsible dental front-office, clinical coordination, patient access, or healthcare administration experience, including scheduling, insurance verification, claim follow-up or rebilling, and treatment-plan support. Equivalent combinations of relevant education and experience may be considered in accordance with University policy.

PREFERRED QUALIFICATIONS

• Bachelor's degree in healthcare administration, business administration, or a related field.
• Experience in an academic dental institution or specialty dental clinic.
• Experience with axiUm or comparable systems, dental preauthorizations, claim follow-up, rebilling, treatment-plan review, record audits, staff training, and clinic reconciliation.