Benefit Specialist

Job Title:  Benefit Specialist

Monday- Friday position, 8:00am to 5:00pm, Non-exempt

Reports to:  Financial Coordinator

Vision of Practice

Southern Arizona Endodontics strives to be the leading endodontic practice in the United States and serves as a resource for the dental community. Above all, our foundation is built on a positive culture, continuing education, and convergent effort.

With passion, selfless commitment, exceptional service, and state of the art technology, our team attends to all in a safe environment that exceeds expectations.  

We accommodate and partner for success with all dental professionals to provide outstanding quality care in a timely fashion. Our patients return to their referring dentist educated and transformed by their experience. In short, we achieve personal and professional fulfillment by defining the standards of unprecedented community service.

Benefit Specialist Vision/Outcome of Possibilities:

Firstly, the Benefit Specialist is the observer of the appointment book for our three locations, Craycroft, Oracle and Green Valley. Also, s/he is quick to review, assess and execute all insurance verification. With efficiency, strong attention to detail as priority and quickness s/he will verify on average 600+ verifications a month.  S/he sets a positive tone for discussions about insurance and patient’s co-insurance before the patient walks through our doors.  Lastly, s/he provides a calm and warm environment for patients who are otherwise anxious and concerned about “how to afford dentistry.”  

To assure growth opportunities for this individual, the Benefit Specialist is also cross-trained within GS2 department. When required s/he can support the Claims & A/Receivable specialists, to ensure that the needs of patient, team and company are fulfilled.

Knowledge, skills and abilities required (KSA):

  • Displays outstanding relationship building skills: build trust, show interest in others, work hard, focus on giving
  • Expert on leased networks and dental insurance plans
  • Exhibit great teamwork skills: Listen, communicate, organize and recognize
  • Market the practice: knowledge of top 10 referrals & charity of the  month
  • Creative problem solving skills: identify, define, examine, act and look (Ideal)
  • Great verbal skills with patients, and insurance companies
  • Complete understanding of office vision: Read “Start With Why”
  • Excellent math skills and attention to detail
  • Ability to work independently and troubleshoot problems 90% of the time, self directed & motivated
  • Expert on Endodontics ADA codes
  • Basic knowledge of collections and bankruptcies
  • Significant knowledge of HIPAA

Key Performance Standards/Statistics

  • Daily, Monthly, and Yearly Verification Goals must be achieved
  • Positive patient comment on the customer service during the verification process
  • Accurate math calculation
  • Attend two education seminars
  • Read two educational books per year
  • Embody the practice philosophy in all actions and decisions

Duties Performed

Most importantly, the number one a responsibility of all employees is to provide & demonstrate to patients, colleagues, and all guests, the SAE WOW factor. This consists of always doing the right thing; exceeding patient’s expectations and enhancing our customer service skills each day.

This guide is an outline of duties which generally must be accomplished daily, weekly, and monthly. Once all tasks are completed, it is the company’s policy to cross-train and/or assists other departments. 

Benefits Specialist duties include, but are not limited to, what is listed below.

  • Prepare a verification action plan by reviewing the appointment book for the next day, to determine treatment priorities
  • Determine insurance eligibility, limitations and payment estimates necessary to facilitate financial arrangements
  • Contact patient before their appointment to provide “estimated out of pocket” expense for treatment.
  • Study & learn most frequent insurance plans. Understand the various challenges of each plan in order to communicate effectively to patients
  • Document all insurance verifications in guarantor notes.
  • Respond to Patient Care emails within 3 minutes from receipt
  • Enter insurance plans not located in our Dentrix database, submit claim
  • Communicate a new or revised policy effecting the most frequent employers to Patient Care
  • Maintain and update the collection reference sheets & flip chart fees
  • Return all patient phone calls (voice mail) with-in two hours, or depending on situation by the end of business day.
  • Educate patients as necessary on basic insurance terminology
  • Upon verification, accurate math calculation must be 95% or higher

Team Work Roles

  • Team member must be productive throughout the day, if not, must assist other team members
  • Proactively communicate with Patient Care any special circumstance regarding pt’s treatment or financial status
  • Participate in huddles by providing vital information for customer service, training and problem solving which pertains to your expertise.
  • Use excellent verbal skills with team members, as well as with patients
  • Partake in company events or committee: Fish, Website, Roundtable, etc…
  • Marketing : Proactively engage with referring office when opportunities  arise: seminars, marketing events, personal dental appointments


Equipment used (includes but not limited to)

  • Software and computer software including MS word and excel
  • 10-key calculator
  • Copier
  • Fax
  • Credit card terminal


Leadership/ Self Direction Responsibility

  • Observe and suggest ways to improve roles or company through our suggestion box.
  • When challenges arise amongst employees the 3-step protocol must be utilize to ensure a collaborate successful outcome
  • Vocalize and demonstrate positive energy when faced with a difficult patient or situation
Scroll to Top