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Dental Biller

Dental Biller

METRO COMMUNITY HEALTH CENTERPittsburgh, PA, US
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Metro Community Health Center Billing Position

Metro Community Health Center extends great benefits to our eligible employees.

MCHC current benefits are :

  • MCHC pays 100% of the employee premium for UPMC Medical, United Concordia dental, STD, LTD
  • Life insurance ($100,000)
  • VBA vision coverage is offered as voluntary coverage that paid for by the employee
  • Medical and Dependent Care FSA and HRA
  • 2 weeks of paid parental leave
  • 20 days (4 weeks) of PTO for your 1st two years
  • 12 paid holidays
  • 401k with a 4% match
  • Competitive Wages

ESSENTIAL FUNCTIONS :

  • Responsible for daily billing operations to ensure maximum productivity, accuracy of claims submission and third party follow up through automated work queues while assisting with resolution of disputed claims.
  • Maintains a good working knowledge of the specific billing requirements for all payers for FQHC.
  • Including assigning appropriate DPT-4 codes and appropriate ICD- 10-CM diagnosis codes selecting the codes that accurately describe the condition for which the service or procedure was performed.
  • Provides ongoing training and development of staff as required to ensure payor requirements are met.
  • Review claims editing reports for consistent errors and follow up with the management for improvement in quality and performance.
  • Analyze and trend billing issues related to A / R, i.e., Specialty, Payer, Provider, etc. for efficiencies while taking proactive approach to resolve A / R issues prior to escalation.
  • Engage in open communication with management regarding information system, third party payor, and regulatory updates and / or enhancements.
  • Contacts patients to obtain, verify, and update account information when necessary
  • Work with the payors and subscribers to resolve issues and facilitate prompt payment of claims.
  • Develop and analyze reports that will monitor claim edit trends
  • Ability to work independently, with minimal supervision. Must be very reliable and punctual as attendance is important for this position
  • Participate in review and evaluation of claim denials to ensure appropriate reimbursement.
  • Participate in assessing claim edits to enhance the billing system functionality and identify user training and development needs.
  • Process monthly patient statements and answer patient inquiries in regard to those statements.
  • Generate patient service invoices in a timely manner.
  • Being familiar with the responsibilities of Patient Access and willing to perform such duties on a daily basis up to but not limited to answering patient calls, scheduling, insurance verification and prior authorizations.
  • The list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities that management may deem necessary from time to time.

    • Qualifications

    POSITION REQUIREMENTS

  • High school graduate or equivalent, bachelor's degree preferred.
  • Must be knowledgeable of medical and dental terminology, electronic and manual claims processing, and third-party payor billing guidelines and reimbursement practices for primary care centers.
  • Must be able to establish priorities, effectively problem solve, and use good judgment and decision making in day-to-day billing operations and work independently.
  • Must have ability to communicate well both orally and in writing. Requires prior working experience on personal computers and various office equipment.
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    Biller • Pittsburgh, PA, US

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