Dental Billing Specialist
3 months ago
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.
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
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