Insurance and Claims Coordinator

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Posting End Date

Note: Applications will be accepted until 11:59 PM on the Posting End Date.

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At UBC we believe that attracting and sustaining a diverse workforce is key to the successful pursuit of excellence in research innovation and learning for all faculty staff and students. Our commitment to employment equity helps achieve inclusion and fairness brings rich diversity to UBC as a workplace and creates the necessary conditions for a rewarding career.

JOB SUMMARY

The UBC Dental Clinic including the Nobel Biocare Oral Health Centre (NBOHC) and the Graduate Specialty Clinic uses state-of-the-art technology and an innovative architectural design to create a sophisticated efficient space for learning community service and research. The clinic provides the setting for the clinical practice components required for the Doctor of Dental Medicine (DMD) program and graduate programs. A new Simulation Laboratory completed in 2022 expanded capacity for patient care while enabling simulated clinical learning in a dedicated space.

The Insurance & Claims Coordinator coordinates and administers all aspects of dental insurance verification claims submission payment reconciliation and patient billing within NBOHC. The role ensures accurate timely processing of high-volume claims and complex financial interactions; composes and sensitive policy-heavy correspondence with third-party insurers and government payors; and responds to confidential patient student and faculty inquiries with tact and discretion. This role partners with Operations and Information Technology teams to interpret and implement changes to Canadian insurance policies including the Canadian Dental Care Plan (CDCP) and BC Ministry of Health programs ensuring process updates are reflected in clinic systems records and communications. Reception coverage is provided on an as-needed basis during absences peak periods or staffing gaps.

ORGANIZATIONAL STATUS

Works within the main dental clinic. This position reports to the Clinic Operations Administrator who reports to the Senior Clinic Manager Resources & Operations and the Clinic Director.

WORK PERFORMED

Insurance & Claims Administration

• Coordinates end-to-end insurance administration workflows including verification of benefits and obtaining pre-authorizations as required.
• Prepares submits and tracks dental claims to third-party insurers (e.g. Pacific Blue Cross Sun Life) and government payors (CDCP Ministry of Health BC) ensuring completeness code accuracy and documentation integrity.
• Investigates appeals and resolves rejected delayed or underpaid claims; drafts complex correspondence to insurers/government payors citing policy provisions and clinical documentation.
• Administers direct billing; communicates patient financial responsibilities (co-pays deductibles non-covered services) with clarity and empathy.
• Serves as the primary point of contact for insurance CDCP and Ministry of Health programs; responds to confidential phone email and in-person inquiries and provides information of a complex nature.
• Monitors aged claims and outstanding balances coordinating with the front desk to secure timely patient payments for rejected or uncovered services.
• Maintains and updates electronic records and claim data across clinic information systems; ensures data quality through routine audits and error-correction workflows.

Patient Financial Support

• Reconciles and allocates payments from insurers CDCP the Ministry of Health and collection agencies to patient accounts; prepares and validates journal entries and adjustments as required.
• Explains insurance benefits billing statements estimates and payment options; navigates complex coverage scenarios with professionalism and tact.
• Collaborates with finance and clinical teams to research and resolve discrepancies; prepares supporting documentation for internal review and audit.
• Maintains accurate current patient financial records in compliance with university and industry standards.
• Delivers or coordinates training for staff students and faculty on insurance claims and coverage processes; develops quick-reference guides and standard work where helpful.
• Provides backup for accounts receivable: monitors outstanding balances reconciles payments and supports patient follow-ups in alignment with finance protocols.

Oral Health Access Fund Program Monitor

• Monitors and reports on Health Canada Oral Health Access Fund expenditures ensuring alignment with CDCP guidelines and clinic eligibility criteria.
• Tracks allocated budgets (e.g. C$100000 for CDCP co-pay coverage; C$232000 for non-insured populations) within the federal fiscal year (Apr 1Mar 31); prepares periodic reconciliations.
• Validates and documents eligible procedures (e.g. crowns root canals prostheses pediatric treatments) and maintains audit-ready records.
• Prepares concise narrative and financial reports (e.g. 500-character limits) for Health Canada; composes sensitive policy-aligned correspondence to clarify eligibility and utilization.
• Liaises with community clinics and stakeholders to support access compliance and optimal utilization of funds.

Documentation & Compliance

• Maintains accurate insurance billing and clinical-adjacent documentation in patient records; ensures completeness confidentiality and version control.
• Ensures compliance with university policies privacy legislation insurer requirements and government payor protocols; implements process improvements to strengthen internal controls and turnaround times.
• Monitors and actions payor updates (insurers CDCP Ministry of Health BC); coordinates updates to procedures templates and system configurations in partnership with IT and Operations.
• Reviews insurance collection accounts prepares and mails monthly statements; coordinates EFT remittances with UBC central finance and reconciles journal vouchers as needed.
• Assists in the development and maintenance of electronic information support systems including distribution lists payer/plan master data and online records administration; enters edits and manipulates complex datasets to support reporting and analytics.

Reception Coverage (As Needed)

• Provides front-desk/clerical coverage during absences peak periods or emergencies; maintains a professional confidential and service-oriented presence.
• Supports patient flow: check-in/check-out appointment scheduling and inquiries; follows escalation pathways for clinical financial or privacy-sensitive matters.
• Ensures continuity of operations by adhering to established office administration procedures and contributing suggestions for improvement.

CONSEQUENCE OF ERROR

Work is performed under clearly defined guidelines requiring minimum judgment on methods used to perform work. Resolves some problems but refer most to the supervisor. Errors can be corrected but could result in patients not receiving treatment when needed causing angry patients faculty and students missing valuable clinical instruction time.

SUPERVISION RECEIVED

Reports administratively to Clinic Operations Administrator. Work is overseen by the Administrative Coordinator and works closely with other Clinic Receptionists and Chart Room Clerk. Interacts regularly with patients students faculty and other staff.

SUPERVISION GIVEN

N/A

MINIMUM QUALIFICATIONS

High School graduation plus one year of post-secondary education plus four years of related experience or an equivalent combination of education and experience

• Willingness to respect diverse perspectives including perspectives in conflict with ones own
• Demonstrates a commitment to enhancing ones own awareness knowledge and skills related to equity diversity and inclusion

PREFERRED QUALIFICATIONS

• Completion of post-secondary education in medical/dental administration or equivalent experience Preferred.
• Experience in dental or medical insurance billing preferably in a clinical or academic setting.
• Strong knowledge of Canadian dental insurance systems and third-party payor processes.
• Familiarity with dental software systems (e.g. Axium) and Microsoft Office.
• Strong interpersonal communication and problem-solving skills.
• High attention to detail and the ability to manage confidential information responsibly.