Dental Billing Specialist

Overview

Our Baystate Dental Central Billing is currently seeking a Billing Specialist to join our team. This Central Billing Office Representative will bill, correct, and enter claim information in the billing system as assigned by leadership as part of the revenue cycle team.

Responsibilities

Perform billing tasks, such as medical and dental claims and preauthorization submissions, ensuring to review and attach necessary x-rays, charting and associated patient notes.

• Work closely with providers and office staff on any follow up questions relating to patient information.
• Make appropriate corrections in DentalXChange to satisfy / edit payer requirements and resubmit claims as needed.
• Appeal complex denials through review of payer policies, coding, contracts, and medical / dental records.
• Assist department supervisor on special projects and staff training.
• Ensure that items in assigned work queue(s) are resolved within required timeframes, using payer website, billing systems, and CBO pathways.
• Sort and scan explanation of benefits (EOB) into patient’s account. Apply adjustments as needed.
• Review and resolve uncollected accounts and prepare charge corrections.
• Review fee schedule to ensure accuracy and make corrections as necessary.
• Identify payer, provider credentialing, and / or coding issues and address them with leadership.
• Other duties as consistent with this role.
• Reconcile payments received to posted payments.
• Audit patient accounts for accuracy.
• Answer incoming phone inquiries and emails from patients and office staff.

Work Environment :

This job operates in a professional office environment. This role routinely uses standard office equipment such as laptop computers, and smart phones.

Physical Demands :

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand;

walk; use hands to finger, handle or feel; and reach with hands and arms. This position requires 30% - 40% travel.

This position requires the ability to occasionally lift products and supplies, up to 20 pounds.

Qualifications

High School Degree required; Associate degree preferred.

Qualifications / Training

• One (1) to two (2) years’ experience working with dental and / or medical insurance billing
• Dentistry or health-care experience preferred. Strong knowledge of dental insurance preferred.
• Experience in sending / posting dental insurance claims, both general dentistry and specialty
• Ability to engage, internally and externally.
• Excellent communication skills, including the confidence to engage with all audiences

Options

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