The Dental Billing Specialist is responsible for accurately and timely researching and resubmitting all claims by creating corrected claims to payers via electronic or paper required to resolve rejected, underpaid and denied claims, payment posting, processing of, ledger auditing, posting all ERAs, EOBs and Counter payment adjustments as per protocol schedule; Manage patient and/or insurance account receivables at a high volume in addition to manage Insurance payment inquiries in a timely manner, responsible for accurately and timely researching and audit patient’s ledgers to ensure that all claims have been properly researched and worked, in addition to verify their true balances on the account prior emitting a statement.
Duties and Responsibilities:
- Strong customer service skills; answering office staff, patient and carrier calls; prompt return and follow up to all interactions; prompt response to requests for information
- Minimum of three or more years work experience with one or more of the following: Third party claims billing, insurance follow up, audit, claims processing and revenue cycle compliance in a Dental office or a Dental service organizations or Dental system revenue cycle department is preferred.
- Must be able to understand Dental Billing, Payment Posting, Cash Posting & Dental Reimbursements.
- Must have working knowledge and experience interpreting third party payer rules to include coordination of benefits, interpreting policy benefits, state and federal regulations, overturning denials and underpayments as well as remain current on all industry changes in billing requirements.
- Identify and bill secondary or tertiary insurances.
- One or more years of experience posting large batches of payments.
- Be able to understand an EOB on its entirety including denial code review in addition to COB with secondary insurance. Identify and bill secondary or tertiary insurances
- Working knowledge of dental terminology, CDT codes and revenue codes for billing is required.
- Ability to effectively present information and respond to questions from patients regarding their account balance.
- Post and review unapplied payments regularly to ensure statement accuracy
- Reviews patient accounts, marks corrections as needed.
- Monitoring and reconciliation of claims
- Supports the department as needed to ensure services performed positively impact the revenue cycle
- Stays current on industry regulations and requirements
Education, Experience, Skills, Qualifications:
- High School diploma or GED is required.
- 1-2 years of experience in the dental insurance billing field.
- Organizational and time management skills and ability to work independently.
- Proficiency in computer keyboarding skills required.
- Ability to effectively gather and exchange information in both oral and written communications.
- Detail oriented, analytical skills, root cause analysis, ability to problem solve and recommend resolutions.
- Ability to use MS Office Suite (Word, Excel, Outlook) at an intermediate level.
- Ability to add, subtract, multiply, and divide in all units of measure. Ability to use critical thinking skills to apply principles of logic and analytical thinking to practical problems.
Salary and Benefits:
- Based on experience
- $16.00-$22.00/hour