Ortho AR Specialist

Orthodontic Accounts Receivable Specialist

The Orthodontic Accounts Receivable (AR) Specialist is responsible for the timely and accurate execution of insurance claims processing, patient AR follow-up, and resolution of account balances. This position is focused on task-level support for collections, including reviewing Explanations of Benefits (EOBs), submitting appeals, correcting billing errors, and contacting payers and patients. The AR Specialist plays a key role in maintaining clean claims, minimizing aging AR, and supporting revenue cycle team goals through dependable daily follow-up activities.

Essential Responsibilities:

• Reads/analyzes Explanations of Benefits (EOBs) for accuracy; determines appropriate follow-up actions.
• Submits dental claims, appeals, and supporting documentation to payers.
• Identifies and corrects billing errors and resubmits claims as needed.
• Conducts root cause research for denied or unpaid claims.
• Uses insurance portals and phone outreach to follow up on claim status.
• Bills work-in-progress, secondary and tertiary insurance when applicable.
• Reviews remittance advice for underpayments or payment discrepancies.
• Escalates recurring payer issues or delays to supervisors as needed.
• Initiates & maintains patient AR follow-up for overdue balances, per internal protocols.
• Coordinates payment arrangements or flag accounts for further collection activity.
• Conducts ledger audits, contract corrections, and AR adjustments with policy alignment.
• Responds to practice-level inquiries via email or ticketing system in a timely and professional manner.
• Supports Cloud9 optimization and contribute feedback to improve workflows.
• Meets assigned productivity benchmarks and team performance goals.
• Expected to work all scheduled days and hours, and to report to work on time.
• Embraces NADG's values, culture, and "Core 3": People First, Access to Care, and Cost Containment.
• Supports the NADG Care Cycle and prioritizes delivering best-in-class patient care.
• Other duties as assigned.

Experience/Requirements:

• Minimum of 2 years in dental revenue cycle, including claims billing and patient collections.
• Proficiency in Microsoft Office Suite.
• Familiarity with insurance portals and eligibility/claim inquiry tools.
• Knowledge of insurance payer guidelines and AR workflows.
• Experience with Cloud 9 or other orthodontic software preferred.

Knowledge, Skills, and Abilities (KSAs):

• Attendance & Reliability: Arrives to work on time; dependable, punctual, and demonstrates strong time management skills.
• Cooperation & Teamwork: Works respectfully and effectively with colleagues; contributes meaningfully to help the practice achieve its goals.
• Communication Skills: Demonstrates clear, organized, and effective written and oral communication; exhibits strong listening and comprehension abilities.
• Customer Service: Provides professional, helpful, and high-quality service to both internal and external customers, addressing patient needs effectively.
• Leadership & Decision-Making: Makes thoughtful, well-reasoned decisions; demonstrates resourcefulness and creativity in problem-solving.
• Initiative & Flexibility: Takes initiative by seeking additional responsibilities; identifies problems and proposes solutions; adapts well to new challenges and unexpected changes.
• Knowledge & Expertise: Possesses a strong understanding of the information, processes, and procedures necessary to perform the role effectively.
• Technical Capabilities: Performs job responsibilities with attention to detail, consistency, productivity, and efficiency, in alignment with company and industry standards.
• Digital Dentistry: Demonstrates knowledge of digital equipment and software used in the practice, including Open Dental, Primescan, Overjet, and others.

Education/Certifications:

• High school diploma or equivalent.
• Additional education or certifications in billing/coding preferred.

Physical/Environmental:

• This is a sedentary role, requiring prolonged periods of sitting and regular use of a computer and other standard office equipment.
• Requires frequent talking, hearing, and visual acuity for computer work and communication.
• May occasionally be required to lift items weighing up to 30 pounds.
• Work is performed in a private home office environment.
• Occasional travel may be required.