Dental Billing Specialist

Reporting to the Dental Billing Coordinator, the Dental Billing Specialist will work exclusively in our billing department, verifying insurances, inputting insurances, submitting claims, payment posting, handling accounts receivable issues, sorting out insurance issues, working with patients to understand their bill and their insurance. The Billing Specialist will also handle insurance denials, inputting insurance checks, AR reports, attach x-rays to claim via NEA, identify narrative request work, outstanding claims, etc. Two years or more of experience with dental or medical is a plus. The Specialist ensures compliance with all company policies as well as state and federal billing and AR regulations.

• Prepares billing documents for collection of revenues from third party payer programs and patients; checks and reconciles patient account balances, verifies payments.
• Reviews billing documents to assure program compliance for PPO and Managed Care insurance programs; assures that all appropriate dental and medical documentation and x-rays are included in the billing package and submitted timely.
• Experience with accounts receivables, coordination of benefits posting electronic payments.
• Expertise in interpreting and processing EOB's / EFT's to post payments.
• Perform payment posting of pay or payments accurately within 24 hours along with proper adjustments
• Work unapplied insurance payments and adjustments.
• Communication with patients and insurance companies regarding patient accounts.
• Respond timely to emails and telephone messages as appropriate. Communicate issues to management including payer system or escalated account issues.
• Responsible for all aspects of follow up and collections on insurance balances including making telephone calls accessing payer websites. Identify issues or trending and provide suggestions for resolution. Accurately and thoroughly documents the pertinent collection activity performed.
• Follow up on insurance aging accounts receivables reports monthly.
• Perform End of Day closing duties including ensuring all charges have been processed for end of day, perform the reconciliation of the daily payment transactions to the Finance Office. Ensure 24-hour turnaround on all work.
• Demonstrated knowledge in patient relations, scheduling, bookkeeping, ADA coding insurance, dental billing, and reimbursement including experience with HMO & PPO plans.
• Perform other assigned tasks and duties necessary to support the Accounts Receivable Department and maintain strict confidentiality of all patient information in accordance with HIPAA.

Education/ Experience

• A college degree (AS) with dental experience OR General education degree or high school diploma with three to five (3 - 5) years of Dental experience.
• Experience in a Dental Office is Required; Clinical background (RDA) is a plus.
• Must have previous experience (3-5 years) working in a heavy customer service environment with heavy customer/patient interaction; prior experience in high volume dental healthcare setting i.e.: hospital or clinic practice – preferred.

Knowledge/ Skills/ Abilities

• Experience in high volume claims adjudication.
• Experience with dental software: Dentrix, AxiUm & NEA Fast Attach Trojan Eligibility and Dental Payor websites.
• Knowledgeable in Universal Tooth Numbering System
• Proactive communication skills (both written and verbal) utilizing tact and diplomacy.
• Exceptional customer service skills and professionalism in communications and demeanor.
• Effective organizational and planning skills including attention to detail and follow-through.
• Adherence to confidentiality, state, federal, and HIPAA laws and guidelines with regards to patient’s records.
• Ability to work equally and collegially with others consistent with a workplace of dignity and respect and EEO rules and regulations.
• Fluent in English Spanish speaking a plus.

Physical Demands

• Able to lift up to 5 lbs.
• This position requires compliance with Touro's Vaccine Mandate policy