About the Position
Your Benefits
- 403(b)
- 403(b) matching
- Dental insurance
- Employee assistance program
- Employee discount
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
What Your Role Requires
JOB TITLE: DENTAL INSURANCE BILLING SPECIALIST
REPORTS TO: Business Office Manager
- JOB SUMMARY / OVERVIEW
- Processes dental, insurance claims, investigates denied claims and posts insurance payments to patients' accounts. Interrelates with providers, insurance companies, other health care organizations, the public and the staff.
- PRIMARY DUTIES
Every effort has been made to include all duties; however, the omission of a specific statement of duties does not exclude the duty from the position if the work is similar, related or is a logical assignment of the position.
- Respond knowledgeably and courteously to inquiries from patients, providers, staff and insurance companies.
- Process insurance claims on a daily basis. Work promptly and efficiently so claims are paid within a 60-day period.
- Follow up on or investigate denials and claims over 30 days old.
- Post payments from insurance companies to proper patient account within 48 hours of receipt.
- Keep abreast of all changes and billable charges within individual insurance companies.
- Maintain list of insurance companies contact information for questions regarding claim issues, encounter rate changes and covered services.
- Place unneeded documents in shred box to protect PHI from unauthorized use or incidental disclosure.
- Refund insurance companies and patients as necessary. Give information to Accountant to issue check.
- Verify incomplete charges weekly.
- Work with CFO/CEO as requested regarding negotiating payment rates for certain procedures.
- Other duties as assigned.
- EDUCATION / QUALIFICATIONS
- High school diploma or GED.
- Experience with dental insurance billing desirable.
- Familiarity with ICD and CPT coding helpful.
- EXPERIENCE / KNOWLEDGE / SKILLS
- Must have an understanding of different types of insurance, including Medicaid and the reimbursement requirements.
- Must have knowledge of general office procedures and equipment.
- Ability to interpret billing and claims reports.
- Ability to function independently in prioritizing and organizing daily work.
- Demonstrate attention to detail.
- Must possess basic computer skills.
- Ability to speak, read, write and comprehend instructions in English.
- 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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- While performing the duties of this job, the employee is regularly required to sit, use hand and fingers, handle and feel objects, reach with hands and arms, talk and hear.
- MISCELLANEOUS
- Accepts and is supportive of change.
- Accepts guidance and suggestions for improvement.
- Willing to assist and work with others.
- Maintain strict and total personnel and patient confidentiality.
- Attend all required in-service meetings and department meetings.
- Complies with PrairieStar Health Center Policy & Procedure.
- Attend all required in-service sessions.
- Attend all required clinic meetings.