Dental Billing Specialist

POSITION SUMMARY   

The Dental Billing Specialist is responsible for timely, accurate and comprehensive billing of all provider services utilizing appropriate CPT, HCPCS and ICD-10 diagnosis codes. This position 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 Billing Specialist will be responsible for monthly dental claim reporting and will assist with dental prior authorizations as needed. The Dental Billing Specialist provides essential support throughout our organization and follows up on submitted claims and patient billing; resubmits claims and/or corrects inaccuracies.  

ESSENTIAL DUTIES AND RESPONSBILITIES: 

• Process dental claims to appropriate primary, secondary, and/or tertiary insurance company according to insurance guidelines.  

• Maintains supporting documentation files and current patient addresses.  

• Researches and responds by telephone and/or in writing to patient inquiries regarding billing issues. 

• Daily electronic claims follow up and submission of all x-rays, periodontal charting or documentation requested from the insurance companies. 

• Follow up with dentists and dental staff as needed to ensure all patient visit documentation is completed before sending claims.  

• Answers patient questions, identifies, and resolves patient billing complaints. 

• Monitors submitted claims; follows up on unpaid claims, and initiates dialogue with insurance companies. 

• Analyzes and resolves claim rejections and denials related to coding or other issues. 

• Resubmits claims to insurance companies, as necessary. 

• Answers questions from patients, dental staff, and insurance companies 

• Identifies and resolves patient billing complaints. 

• Evaluates patient’s financial status and establishes budget payment plans. 

• Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers. 

• Follows and reports status of delinquent accounts and works with patients to establish payment plans. 

• Follows up with the provider on any documentation. 

• Assists with dental billing and documentation training as needed. 

• Other duties as assigned. 

EDUCATION / QUALIFICATIONS / REQUIREMENTS  

• A high school diploma or GED is required. 

• Minimum of two (2) years of medical billing experience in a primary care setting required. 

• Expert knowledge in health information practices, concepts, and legal requirements required. 

• FQHC billing experience preferred. 

• Excellent customer service skills. 

• Ability to establish and maintain effective working relationships with patients, staff, and dental team.  

• Ability to work in a fast-paced office setting. 

• Ability to work independently on assigned tasks, as well as to accept direction on given assignments. 

• Ability to handle confidential information and/or issues using discretion and judgment. 

• Knowledge of (ICD-10), CPT-4, HCPCS and modifier usage 

• Bilingual/Spanish skills are preferred.