Dental Billing Specialist
GENERAL RESPONSIBILITIES
Responsible for processing claims to maximize collections on all patient accounts.
ESSENTIAL DUTIES
- Manages patient information in practice management system as it relates to changes in patient's insurance coverage, including E-Med and Medicaid. Based upon verification of third-party insurance eligibility, transfer charges in the practice management system from one expected payor to another in order to generate accurate claims and statements. Makes adjustments as appropriate for OB accounts after delivery and/or due to patient transfer of care. Makes other changes to patient billing information as requested by patient or staff.
- Reviews third-party payor denials and determines appropriate course of action in order to collect on the account. Determines the reason for the denial and provides the insurer with the appropriate documentation for the claim to be paid. Follows-up with third party insurance carriers on unpaid claims until claims are paid or only self-pay balance remains.
- Monitors ticket statuses on a weekly basis to ensure problems in billing are identified in a timely manner, corrects the problems, rebills claims to payors.
- Tracks third-party payment amounts, pended claims numbers and amounts and has a general sense of payor denials to identify any potential cash flow problems with individual payors. Through tracking these trends can identify problems, successes or inconsistencies of the major medical and dental payors; Medicare, Medicaid, Blue Cross (medical and dental), Blue Shield and Delta Dental.
MINIMUM QUALIFICATIONS
- Minimum 2 years medical office experience with knowledge of diagnosis (ICD) and/or procedure (CPT) and/or dental (ADA) coding systems.
- Demonstrated knowledge and understanding of Medicare, Medicaid and major insurance carrier regulations, procedures and benefit plans.
- Two or more years’ experience billing third-party insurances.
- Requires minimal supervision and direction with ability to make sound decisions.
- Highly ethical and non-judgmental.
- Strong customer service skills..
- Able to analyze and resolve problems.
- Ability to effectively communicate and interact with physicians and coworkers, hospital staff, third-party payors, patients and the public.
- Ability to read and follow oral and written instruction.
- Must be able to use hands repetitively with good dexterity.
- Able to sit for long periods of time.
- Computer proficiency.
PREFERRED QUALIFICATIONS
- Five or more years of experience in a medical and /or dental office.
- Experience billing FQHC Medicare and FQHC Medicaid.
- Bilingual in English and Spanish.
- Certified Professional Coder credential.
Terry Reilly Health Services is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identify, national origin, disability, or protected Veteran status.