We are looking for an organized, adaptable and experienced Medical Billing Specialist for Dental group.
The Medical Billing Specialist is responsible for achieving the billing targets of the practices. This person must have prior dental billing experience and be familiar with Government and Commercial Insurance plans.
Key Responsibilities
- Posting CDT codes to patient’s ledger based on provider clinical notes according to billing guidelines
- Submission of insurance claims using practice management software
- Ensuring claims are submitted with correct attachments such as x-rays, narratives, perio charting and intraoral photos
- Ascertaining why claims have been rejected and implementing corrective measures
- Identifying irregularities such as missing payments, missing procedures etc in patient accounts
- Responsible for reconciling all payments received by the practice through multiple payment methods
- Processing prior authorizations for procedures on behalf of the patient
- Auditing clinical notes by treatment coordinators and posting procedures to patient’s treatment plan
- Compiling dental records in response to requests from patients and dental insurances
Qualifications
- Experience in Dental Office setting of at least 5-10 years
- Excellent knowledge of Dental Insurances, specifically PPO, DMO, DHMO (Capitation), and NYS Managed Care Programs
- Understanding In-network /Out-of-network benefits as well as fee for service
- Possess working knowledge of General Dentistry and Orthodontics such as common procedures and treatment
- Up to date knowledge of ADA billing guidelines including CDT coding updates and frequency limitations
- Strong English written and verbal communication skills to effectively relate data to coworkers
- Excellent critical thinking skills to help solve business problems and make decisions
- Possess our core values of commitment, quality, respect, communication and teamwork
- Demonstrated ability to manage time and prioritize projects to meet deadlines
- Have a high speed internet connection and dedicated workspace in order to work from home
- Ability to maintain confidentiality regarding highly sensitive issues
- Ability to work collaboratively with managers and team members in NYFD Field Operations and NYFD HQ Operations
General Skills
- Insurance verification
- Claims processing
- Payment posting
- RCM
- Dental Insurance Plans
- EOBS
- Fee Schedules
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