Pediatric OR Scheduler/Insurance Plan Builder at Archway Dental Partners – Danbury, Connecticut

Key Responsibilities

Pediatric OR Scheduling

• Coordinate all aspects of pediatric operating room (OR) cases
• Communicate with patients/parents regarding procedures, expectations, and timelines
• Schedule pre-operative appointments and confirm OR dates and start times
• Facilitate medical clearances with Primary Care Physicians (PCPs)
• Ensure all required documentation (H&P, hospital forms, etc.) is completed and submitted on time
• Collaborate with providers to review medical histories and confirm appropriate case placement
• Submit and track medical insurance pre-authorizations
• Maintain accurate records and ensure all case details are complete prior to surgery

Insurance Plan Building — Dentrix Ascend

• Build and maintain insurance plans in Dentrix Ascend with accurate fee schedules, coverage tables, and plan details
• Set up new insurance carriers and update existing plans as benefit information changes
• Verify insurance plan accuracy to support clean claim submission and reduce denials
• Coordinate with the billing team to resolve plan discrepancies and ensure proper claim routing
• Review and update coverage percentages, frequencies, and limitations within Dentrix Ascend
• Maintain organized records of insurance plan documentation and benefit breakdowns

Billing & Follow-Up

• Enter treatment accurately into the patient ledger
• Support proper billing and documentation for OR cases
• Follow up on outstanding balances after claim processing

Additional Responsibilities

• Manage the full provider credentialing process to obtain and maintain hospital privileges, enabling the doctor to treat patients in the hospital setting
• Complete and submit credentialing applications to hospitals and credentialing bodies on behalf of the provider
• Track credentialing timelines, expiration dates, and renewal requirements to ensure uninterrupted hospital access
• Maintain an organized credentialing file, including malpractice insurance, DEA certificate, state dental license, BLS/ACLS, and all required hospital-specific documentation
• Serve as the primary point of contact between the practice and hospital medical staff offices throughout the credentialing and re-credentialing process
• Ensure compliance with all office and hospital credentialing requirements

Qualifications

• Previous dental or medical office experience preferred (pediatric experience a plus)
• Experience with Dentrix Ascend or similar dental practice management software strongly preferred
• Familiarity with dental insurance plans, fee schedules, and benefit structures
• Strong organizational and time management skills
• Excellent communication and customer service abilities
• Experience with insurance verification and pre-authorizations preferred
• Ability to manage multiple priorities in a fast-paced environment