Dental Billing Specialist

3 months ago


Charleston, United States FETTER HEALTH CARE NETWORK INC Full time
Job DescriptionJob DescriptionDescription:

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




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