Healthcare Billing Specialist
7 days ago
We are seeking an experienced Medical Billing Specialist to join our team at New York Family Dentistry. The ideal candidate will have a strong background in medical billing and be proficient in working with various dental insurance plans.
Key Responsibilities- Billing & Claims Management:
- Post CDT codes to patient ledgers based on clinical notes, adhering to billing guidelines.
- Submit accurate insurance claims using practice management software.
- Ensure claims are submitted with all necessary attachments (e.g., x-rays, narratives, perio charting, intraoral photos).
- Investigate rejected claims and implement corrective measures for resubmission.
- Identify and resolve issues such as missing payments or procedures in patient accounts.
- Reconcile payments received by the practice through various payment methods.
- Process prior authorizations for procedures as required.
- Audit clinical notes and collaborate with treatment coordinators to update patient treatment plans.
- Compile dental records in response to patient and insurance requests.
- Insurance Knowledge:
- Demonstrate a strong understanding of dental insurance plans, including PPO, DMO, DHMO (Capitation), and NYS Managed Care Programs.
- Understand in-network and out-of-network benefits, as well as fee-for-service arrangements.
- Stay current with ADA billing guidelines, CDT coding updates, and frequency limitations.
- Communication & Problem Solving:
- Strong written and verbal communication skills to effectively convey data and resolve issues.
- Excellent problem-solving abilities and attention to detail to ensure accurate billing and timely claim submissions.
- Ability to collaborate with team members, management, and external stakeholders to improve processes and resolve billing issues.
The estimated annual salary for this position is $65,000-$85,000 depending on experience.
Requirements- Experience & Knowledge:
- Minimum of 5-10 years of experience in a healthcare office setting, with a understanding of both dental and medical billing processes.
- Proficiency in working with various dental insurance plans, including PPO, DMO, DHMO, and government programs.
- Solid understanding of medical billing procedures, including handling claims and working with commercial and government insurers.
- Familiarity with ADA billing guidelines and the latest CDT coding updates.
- Skills:
- Strong numerical aptitude and attention to detail.
- Proficient in Microsoft Office Suite (Excel, Word, etc.) and Google Workspace (Google Sheets, Docs, etc.).
- Strong organizational skills, with the ability to manage multiple tasks simultaneously.
- Excellent interpersonal skills with the ability to communicate clearly and professionally.
- Ability to troubleshoot billing discrepancies and proactively resolve issues.
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