DENTAL BILLER

CCI Health Services' mission is to deliver high quality, accessible care to our community members, leading the way to a more equitable health care system for everyone.

POSITION SUMMARY: The Dental Biller at CCI is responsible for the accurate and timely filing of all dental insurance claims, payments, denials, and appeals. This position monitors patient accounts, collects and posts payments from insurance companies and provides information to patients as needed. The dental biller will be responsible for monthly dental claim reporting and will assist with dental prior authorizations as needed.

DUTIES & RESPONSIBILITIES

* Review coding to ensure the correct procedure codes and information is completed.
* Follow up with dentists and dental staff as needed to ensure all patient visit documentation is completed before sending claims.
* Process dental claims to appropriate primary, secondary, and/or tertiary insurance company according to insurance guidelines.
* Accurate and timely review, reconcile, and post patient and insurance payments, both by EFT and check.
* Daily electronic claims follow up and submission of all x-rays, periodontal charting or documentation requested from the insurance companies.
* Resolve claim denials with insurance and resubmit as appropriate including any requested information.
* File appeals necessary on all denied or outstanding claims.
* Working with payers to resolve claim issues
* Actively reviewing claims rejection reports and correcting any issues
* Actively work any insurance denials or no pays
* Researching outstanding claims >30 days in a timely manner
* Reviewing claims submission for accuracy
* Monitor the Accounts Receivable, which includes collecting any patient balances and assigning any accounts to the collection agency as needed.
* Review patient accounts for accuracy and completeness before sending patient monthly statements.
* Ensure that insurance pre-authorizations are received prior to service provision.
* Provide daily, monthly, or as needed dental reports as requested.
* Assist in credentialing or recredentialing dental providers as needed.
* Correct account set up errors (guarantor, demographics, insurances, etc.).
* Ensure that all dental insurance plan coverages are updated in the practice management system
* Daily - Reviewing insurance benefits for accuracy
* Assisting and fee schedule updates
* Swiftly documenting self-reporting on incorrect insurance payments
* Submitting refunds request for any payments made in error
* Submitting corrective claims for any incorrect procedures rendered
* Evaluates patient financial status and established budget payment plans or eligibility for Sliding Scale consideration.
* Must ensure open and constructive coordination with health center personnel in maintaining accuracy in data elements and processing crucial to effective claims processing and account resolution.
* Must ensure adherence with all HIPAA Regulations and Compliance Regulations ensuring the protection of PHI (Patient Health Information).

MINIMUM QUALIFICATIONS:

* Minimum High School diploma, an AA or BS degree preferred or commensurate experience.
* Must have at least 2 years of relevant work experience in a dental office managing insurance claims, reimbursement and patient accounts.
* DENTAL experience REQUIRED
* Strong attention to detail.
* Must be familiar with dental coding an billing.
* Strong customer service skills - bilingual (English/Spanish) is a plus.
* Must be assertive and goal oriented.
* Familiarity with computerized systems is required.
* Must be a willing participant in ongoing educational activities and a contributing participant in staff meetings

CCI Health Services is an Equal Opportunity Employer

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