Responsibilities
- Processing dental claims for payment by insurance companies to ensure appropriate and timely coding, billing and collections
- Performs manual and electronic posting functions for all payors/patient accounts, including cash balancing and reconciliation of bank deposits.
- Post payment corrections, payment transfers and NSF’s.
- Research and clear unapplied accounts using established identification functions/process.
- Maintains knowledge of insurance rejections/denial processing and appropriately posts information for collection and follow up activity.
- Responsible for all aspects of follow up and collections, including making phone calls, accessing payer websites.
- Identify issues or trending and provide suggestions for resolution.
- Accurately and thoroughly documents the pertinent collection activity performed.
- Review the account information and necessary system applications to determine the next appropriate work activity.
- Reviews investigate and resolves claims that have been rejected or denied by insurance.
- Verify claims adjudication utilization appropriate resources and applications.
- Perform appropriate billing functions, including manual re-bills as well as electronic submission to payers.
- Edit claims to meet and satisfy billing compliance guidelines for electronic claim submission.
- Initiates appeals and ensures all required documentation is submitted in the appeal process.
- Answers patient billing questions and act as a resource for patient billing questions.
- Ledger accuracy and account integrity
- Analyzes and correct insurance account receivable and payment posting ledger and posting errors
- Thoroughly research all payor recoupments and identify errors and/or opportunity to dispute and restore loss in revenue.
- Research and validate patient refunds
- Verification of insurance benefits utilizing website, fax and phone.
- Reviewing patient accounts to determine and correct any discrepancies; account audits, aging AR, unapplied adjustments, resolving credit balance, unposted payments
- Researches and follow up on all correspondence associated with assigned accounts
- Other duties and responsibilities as assigned by leadership
Requirements
- High School Diploma or equivalent
- Minimum 3-5 years Dental or Medical Experience
- Prior experience in Dental Office workflows, Revenue Cycle functions to include scheduling, registration, insurance verification, fee schedules, claim submission, charging/coding requirements, insurance AR follow up and payment posting process
- Experience with practice management software systems, insurance portals, clearing houses, insurance guidelines, banking reconciliation software, proficient in intermediate PC skills (MS Office—strong excel skills).
- Strong computer literacy, excellent Math and problem-solving skills.
- Data entry and 10-key by touch.
- Strong interpersonal and organization skills.
- Ability to work within a team setting and as an individual contributor.
- Proven attention to detail with strong analytical skills
Benefits
- A comprehensive benefits package including 401k
- Competitive paid time off for full-time and part-time team members which increases as you grow in your career with us
- Constant opportunities for career growth and continuing education
- A professional and flexible atmosphere that allows for freedom and individuality – enabling our team to always strive to do what’s best for the patient
Team
Structure: Revenue Cycle Team
Additional Information
- Equal Opportunity Employer: all qualified applicants will receive consideration for employment without regard to race, color, ancestry, religion, sex, sexual orientation, gender identity, age, national origin, disability, protected veteran status, or any other characteristic protected by law.
