Careers

Dental Billing Specialist

Summary of Duties: The Dental Billing Specialist is responsible for managing dental claims throughout the revenue cycle, from pre-submission review and claim submission through insurance follow-up and resolution of outstanding accounts receivable. This role works to ensure claims are complete, accurate, and submitted timely; identifies and resolves claim rejections and billing issues; and follows outstanding claims through final resolution.

The Dental Billing Specialist must have a strong understanding of dental billing practices, insurance requirements, claim submission processes, dental terminology and coding, and accounts receivable follow-up. The position requires the ability to research claim issues, identify the appropriate next action, communicate effectively with insurance payors and client teams, and maintain accurate documentation of billing activity.

Essential Functions:

• Review dental claims for accuracy and completeness prior to submission in accordance with payor requirements and client procedures.

• Identify and correct billing errors, missing information, and required documentation or attachments prior to claim submission.

• Submit electronic and paper claims accurately and timely and verify successful claim acceptance.

• Review and resolve clearinghouse rejections and other claim submission issues.

• Work assigned accounts receivable and prioritize outstanding claims based on aging, balance, claim status, and timely filing requirements.

• Research and follow up on unpaid, underpaid, rejected, and denied claims using insurance portals, clearinghouses, and direct payor communication.

• Review payor responses and EOBs to determine appropriate next steps for claim resolution.

• Correct and resubmit claims and prepare appeals or supporting documentation when appropriate.

• Document claim status, follow-up activity, actions taken, and next steps accurately.

• Identify recurring billing issues, denial trends, and process gaps and communicate findings to appropriate team members.

• Meet established productivity, quality, and follow-up expectations.

• Perform other billing and revenue cycle functions as needed based on client and business needs.

Education: High School Diploma or GED.

Skills/Experience:

• At least two years of billing experience

• A background in dental facility preferred.

• ·Knowledge of medical billing/insurance practices

• Knowledge of billing computer software

• Knowledge of business office procedures

• Comprehensive understanding of how to process paper and electronic medical claims.

• Knowledge of basic medical coding and third-party operating procedures and practices

• Ability to read, understand, and follow oral and written instructions.

• Ability to establish and maintain effective working relationships with insurance company representatives and colleagues.

• Must be well organized and detail oriented.

• A positive attitude

• A strong desire to succeed.

Environmental/Working Conditions: Normal office environment. Occasional over time may be required and/or hours may be shortened as business needs dictate.

Physical Demands: Requires sitting and standing associated with a normal office environment. Manual dexterity needed for using a calculator and computer keyboard.

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, skills and working conditions may change as needs evolve.