Dental Billing Specialist

Description

Under the supervision of the Director of Financial Services the Dental Billing Specialist is responsible for the timely completion of all billing functions to include: maintaining accurate patient account records, processing payments and changes, as well as timely payer reimbursements and follow- up for denied claims. 

ESSENTIAL DUTIES AND RESPONSIBILITIES (Included but not limited to the following);

• Review dental records to verify proper coding (based on current coding guidelines) and work with clinical staff. 
• Ensure dental records are signed by appropriate parties. 
• Effectively manage coding and billing -related inquires from both patients and providers.
• Process timely claim submissions (to include insurance and demographic information) with a goal of zero errors.
• Continuous follow-up and resolution for insurance claim denials, exceptions, or exclusions.
• Contact insurance payer regarding claim denials, to include appeal submission with appropriate documentation.
• Respond to inquires from insurance companies, patients, and providers. 
• Monitor monthly aging A/R reports to process claims aged over 30 days. 
• Identify coding and billing errors and work with clinical staff to ensure services are submitted to appropriate payors for billing. 
• Identify and communicate to supervisor patterns of billing errors, inaccurate payments, and posting errors. 
• Timely charge acceptance and processing to include appending necessary modifiers.
• Identify patterns of billing errors, inaccurate payments, posting errors and communicates any needed system changes to direct supervisor.
• Reduce overall delinquent patient A/R.
• Create and maintain meticulous records of follow-up efforts via billing system. 
• Understand and adhere to HIPAA and PHI guidelines. 
• Perform other job-related duties as assigned. 

Requirements

EDUCATION AND EXPERIENCE

• High school graduate or equivalent
• Minimum one (1) year medical billing experience, or equivalent combination of experience, training, and/or education. 
• Excellent verbal and written communication skills and strong interpersonal skills.
• Certified Professional Coder (CPC) certification and FQHC experience preferred