Job Title: Dental Billing Specialist
Department or Practice: Billing/Administration
Location: Great Barrington, MA
Level/Salary Range: Commensurate with experience
Position Type: Full-time, benefits eligible
The Dental Billing Specialist reviews electronic dental records, computer generated reports, and other reporting tools to identify conditions treated and the services provided to each patient. This role is responsible for overseeing the timely and accurate coding of diagnoses, services and procedures performed by dentists, hygienists, and any other provider performing billable services, and supplies used utilizing the appropriate coding system. Excellent customer service and communication skills are required for this position. Spanish speaking/bilingual is a plus. This position also monitors and resolves all aged receivables.
The Dental Billing Specialist contributes to a work environment that is caring, collaborative, and innovative. This person will support CHP’s mission, vision, and values and will adhere to compliance protocols as well as CHP’s policies and procedures.
|Essential Duties and Responsibilities: other duties may be assigned|
- Review EMR billing system, computer generated reports and other reporting tools to identify all services and procedures performed by providers, and any other provider performing billable services; review encounter forms to ensure appropriate diagnosis codes selecting the codes that accurately describe the condition for which the service or procedure was performed.
- Prepare accurate claims for timely submission to the appropriate third party payers; post third party payments received to appropriate patient accounts, file Explanation of Benefits (EOB) according to clinic procedure; work cooperatively with third party payers to reconcile payments in a timely manner; ensure that dental staff complies with various third party rules and regulations; analyze all and investigates all third party claims that become 60 days past due to determine cause. Distributes overdue/denied claims and reports to dental, fiscal and administrative leadership.
- Collaborate with Practice Mangers to monitor, review and tracks all correspondence from insurers regarding claims; Investigate all denied claims, correct any coding errors and resubmit the claims for payment.
- Assist with provider billing and documentation training as needed; maintain all payer training manuals and updates; notify dental staff of any change in any insurer’s rules and regulations.
- In collaboration with the billing team, follow and reports status of delinquent accounts and works to collect aged balances; evaluate patient financial status and establish payment plans as instructed.
- Apply payments to accounts received through bank deposits and insurance carriers; prepare and mail statements to patients with unpaid balances; answers patient questions, identify and resolve patient billing complaints.
|Education and/or Experience:|
High school diploma or GED. Credentials: Certified Professional Coder (CPC); Experience: at least one year coding and billing experience in a dental office.
|Competencies: To perform the job successfully, an individual should demonstrate the following competencies|
- Ability to interact with others with tact and diplomacy; treat others with respect and consideration regardless of status or position; contribute to a positive team spirit; balance team and individual responsibilities; display highest degree of professionalism and ethics.
- Respond appropriately to patient needs; manage difficult or emotional patient situations in a way that instills trust and respect; solicit feedback to improve performance.
- Ability to manage multiple priorities; work well under pressure; complete tasks correctly and on time with limited supervision; step in when needed and cross train for additional site coverage; respond promptly to requests for service and assistance; confidence in leading and instructing others; ability to delegate effectively.
- Ability to effectively present information in one-on-one or small group situations; respond well to questions; complete administrative duties accurately and timely.
- Ability to calculate figures and amounts; solve practical problems; interpret a variety of instructions furnished in written, oral, diagram or schedule form.
- Punctual and reliable; ability to maintain schedule commitments.
- Spanish speaking/bilingual is a plus.
- Knowledge of medical terminology, anatomy and physiology; knowledge of CDT and modifier usage; knowledge of third party payer reimbursement policies and procedures; knowledge of coding and billing programs and ability to use coding and claims software; knowledge of Electronic Medical Record system preferred.
To apply for this position, please submit each of the following:
– Letter of Interest
|Applications accepted by:|
Kelly Krok, Director, Human Resources
Community Health Programs, Inc.
444 Stockbridge Rd. / P.O. Box 30
Great Barrington, MA 01230