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Claims Processing Specialist
2 months ago
Overview:
Smile Brands is a leading entity in the dental industry, currently in search of an Insurance Billing & Collections Specialist to enhance our Revenue Cycle Management team.
Schedule (days/hours):
Monday - Friday
Key Responsibilities:
• Engage with insurance providers or relevant research channels to confirm the status of claims and ascertain payment outcomes or denial reasons.
• Communicate and follow up with representatives from insurance companies.
• Revise patient accounts to rectify any inaccuracies, including demographics, eligibility periods, termination dates, and contractual allowances or limits.
• Oversee the workflow of assigned accounts, ensuring timely submissions to maximize reimbursements while monitoring collection activities for prompt payments from all revenue streams.
• Stay updated on procedural changes, billing regulations, and laws pertaining to specific insurance carriers or payers.
• Pursue overdue accounts and investigate reasons for unpaid balances.
• Audit insurance claims to identify necessary attachments and ensure their completeness and appropriateness.
• Address zero or partially paid EOBs and take necessary actions to appeal or properly adjudicate claims.
• Ensure timely submission of claims for secondary coverage.
• Respond to claim inquiries and tracing within established filing limits.
• Conduct comprehensive audits of patient accounts to determine the appropriate course of action.
• Prepare and dispatch all dental billing and collection correspondence according to the designated schedule.
Qualifications:
• Minimum of 1 year of experience in a comparable role within the Dental or Healthcare sector.
• Professional and courteous phone communication skills.
• Exceptional customer service abilities.
• Detail-oriented, organized, and capable of working independently.
Compensation:
$18 - $19 per hour
About Us:
Benefits are contingent upon employment status and hours worked, including paid time off (PTO), health, dental, vision, health savings accounts, telemedicine, flexible spending accounts, life insurance, disability insurance, employee discount programs, pet insurance, and a 401k plan.
Smile Brands supports over 650 affiliated dental practices across multiple states, all dedicated to a unified mission of delivering smiles for everyone—patients, providers, employees, and community partners alike.
This position is associated with the affiliated dental office listed at the top of the job posting on our career site.
Smile Brands Inc. and all Affiliates are Equal Opportunity Employers. We celebrate diversity and are committed to fostering an inclusive workplace for all employees. We are proud to be an equal opportunity employer.We prohibit discrimination and harassment of any kind based on race, color, creed, gender (including gender identity and expression), religion, marital status, registered domestic partner status, age, national origin, ancestry, physical or mental disability, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), protected hair styles and textures (The CROWN Act), genetic information, sexual orientation, military and veteran status, or any other consideration made unlawful by federal, state, or local laws.
If you would like to request an accommodation due to a disability, please contact us.