Job Details

Third Party Insurance Claim Specialist

Position Number: 6683263
Location: Augusta, GA
Position Type: Health - Healthcare Administration

Third Party Insurance Claim Specialist

Job ID: 291837
Location: Augusta University
Full/Part Time: Full Time
Regular/Temporary:

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About Us

Augusta University is Georgia's innovation center for education and health care, training the next generation of innovators, leaders, and healthcare providers in classrooms and clinics on four campuses in Augusta and locations across the state. More than 12,000 students choose Augusta for educational opportunities at the center of Georgia's cybersecurity hub and experiential learning that blends arts and application, humanities, and the health sciences. Augusta is home to Georgia's only public academic health center, where groundbreaking research is creating a healthier, more prosperous Georgia, and world-class clinicians are bringing the medicine of tomorrow to patient care today. Our mission and values https://www.augusta.edu/about/mission.php make Augusta University an institution like no other.

Augusta University's distinct characteristics in education and research include real-world experiences and community engagement, as well as a culture of building community, corporate and government partnerships that address health, security, economic and societal concerns locally and across the state.

The University System of Georgia https://www.usg.edu/hr/orientation/welcome_to_the_board_of_regents_university_system_office is comprised of our 26 institutions of higher education and learning as well as the System Office. Our USG Statement of Core Values are Integrity, Excellence, Accountability, and Respect. These values serve as the foundation for all that we do as an organization, and each USG community member is responsible for demonstrating and upholding these standards. More details on the USG Statement of Core Values and Code of Conduct are available in USG Board Policy 8.2.18.1.2 and can be found online at https://www.usg.edu/policymanual/section8/C224/#p8.2.18_personnel_conduct.

Additionally, USG supports Freedom of Expression as stated in Board Policy 6.5 Freedom of Expression and Academic Freedom found online at https://www.usg.edu/policymanual/section6/C2653.

Location

Augusta University -

Our Health Sciences Campus:

1120 15th Street, Augusta, GA 30912

Our Summerville Campus:

2500 Walton Way, Augusta, GA 30904

College/Department Information

The Dental College of Georgia at Augusta University, we provide dental education to the next generation of professionals by offering hands-on education through innovative research, patient care, and service. Join other dental providers to improve the oral health of Georgia and beyond. The DCG was founded to provide the people of Georgia with quality dental care by educating students in dentistry. As a patient, you have the option to receive treatment in one of our three different practice models consisting of student clinics, resident care, or in the faculty practice. All dental treatments can be completed by the specialists in our facility. We also serve patients in more than 20 clinics across Georgia.

Job Summary

The Third-Party Insurance Claim Specialist is responsible for overseeing and managing all aspects of veteran dental care coordination within the Dental College of Georgia. This position serves as the primary liaison between the VA, veteran patients, faculty, and clinical staff to ensure the delivery of high-quality, timely, and compliant dental services. The coordinator ensures that all VA authorizations are properly obtained, processed, and tracked, and that communication remains clear and consistent across all parties. Additionally, the role involves maintaining strict adherence to federal guidelines, institutional policies, and VA protocols, while supporting clinical operations through scheduling, documentation review and patient support. This position is critical to optimizing care delivery and enhancing the veteran patient experience within the Dental College.

Responsibilities

The duties include, but are not limited to:

VA AUTHORIZATION: Manage and process VA authorizations for dental services, such as Oral Medicine, Endodontics, and Faculty Practice, ensuring all documentation is thoroughly reviewed and verified for accuracy and completeness.

COMMUNICATION: Maintain clear and professional communication with VA case managers, providers, and administrative staff. Act as a primary point of contact between the Dental College of Georgia and VA representatives.

ACCURATE RECORDS: Accurately input and update patient information in the practice management system. Ensure all treatments are documented in accordance with VA requirements.

COLLABORATE: Collaborate with the billing team to ensure proper coding and submission of VA claims. Monitor and follow up on outstanding claims or denials related to VA authorizations.

GUIDELINES & POLICIES: Stay up to date with current VA guidelines and changes to the Community Care program. Provide regular updates to clinical and administrative staff regarding policy changes.

OTHER DUTIES: Perform all other job-related duties as assigned.

Required Qualifications

Associate's degree in a related field from an accredited college or university and one year experience.

OR

High School Diploma/ GED from a recognized State or Federal accrediting organization plus four years of progressively responsible office support experience with medical and/or dental insurance.

Preferred Qualifications

Associates or bachelors degree from an accredited college or university in a related field.

Preferred Experience
Experience in a dental office or practice with preauthorization's, coding and/or scheduling. Experience with axiUm, MiPacs, VA HRMS. Ability to speak Spanish is a plus.

Knowledge, Skills, & Abilities

KNOWLEDGE

Proficient in Microsoft Office and other computer software/databases.

Knowledge of CDT, ICD & CPT coding

Insurance billing knowledge, Dental/Medical, HMO, PPO, Medicaid, 3rd party billing,

SKILLS

Problem solving to resolve ADA/HCFA claims issues.

Strong organizational skills

Excellent interpersonal, written and verbal communication skills

ABILITIES
Ability to maintain confidentiality.

Shift/Salary/Benefits

Conditions of Employment

All selected candidates are required to successfully pass a Background Check review prior to starting with Augusta University.

If applicable for the specific position based on the duties: the candidate will also need to have a credit check completed for Positions of Trust and or approved departmental Purchase Card usage.

Motor vehicle reports are required for positions that are required to drive an Augusta University vehicle.

For Faculty Hires: Final candidates will be required to provide proof of completed academic degree(s) as well as post-secondary coursework in the form of original transcript(s). Those candidates trained by a foreign institution will also be required to provide an educational/credential evaluation.

All employees are responsible for ensuring the confidentiality, availability, and integrity of sensitive [patient, student, employee, financial, business, etc.] information by exercising sound judgment and adhering to cybersecurity and privacy policies during their employment and beyond.

Other Information

Augusta University is a tobacco-free environment, and the use of any tobacco products on any part of the campus, both inside and outside, is strictly prohibited.

Equal Employment Opportunity

Augusta University is proud to be an equal opportunity employer welcoming applicants from underrepresented groups, including individuals with disabilities and veterans.

How To Apply

Consider applying with us today!

https://www.augusta.edu/hr/jobs/

Select University Faculty & Staff > External Applicants if you are a candidate from outside the university

Select University Faculty & Staff > Internal Applicants if you are a current university employee

If you need further assistance, please contact us at 706-721-9365

To apply, visit https://careers.hprod.onehcm.usg.edu/psp/careers/CAREERS/HRMS/c/HRS_HRAM_FL.HRS_CG_SEARCH_FL.GBL?Page=HRS_APP_JBPST_FL&Action=U&FOCUS=Applicant&SiteId=12000&JobOpeningId=291837&PostingSeq=1