Medical Billing Specialist

Patient Account And Reimbursement Services

Provides patient account and reimbursement services for all units of the agency that requires third party and other billing related functions (with the exception of grants and contracts).

None

Essential Functions:

• Ensures accounts receivables (AR) records are maintained in a confidential manner and in accordance with standard accounting procedures.
• Maintains appropriate internal controls over accounts receivables.
• Ensures security of cash payments on accounts.
• Monitors accounts sent for collections and reimbursements from insurance companies and other third party payers.
• Keeps abreast of all reimbursement billing procedures of third party and private insurance payers and government regulations.
• Monitors and provides updates on the dental billing trends.
• Responsible for reviewing and distributing correspondence relative to the denial of insurance payment
• Communicate effectively with patients and insurance companies regarding payment policies and financial obligations for dental services.
• Responsible for communicating with insurance companies, or other related entities regarding claims
• In conjunction with the Billing Manager, prepares reports, statistics and surveys related to billing, collections and reimbursements for dental services.
• Responsible for reading, interpreting, and processing Explanation of Benefits (EOB) in a timely and efficient manner
• Responsible for reporting billing related issues, timely, to the Billing Manger
• Duties will include but is not limited to the following: processing claim denials, verification of insurance/claim status, resubmission of claims, follow up and maintenance of claims, patient assistance with billing issues.
• Submit the required billing information to any offsite billing services as required to ensure efficient dental billing services.
• Submit ongoing information to providers to ensure billing codes are accurate.
• Monitor collection trends and contact patients as necessary regarding outstanding payments.
• As needed assist patients with billing issues and reconciliations
• Work with the dental department Practice Manager and front desk staff has necessary to ensure that procedures are in place to ensure accurate billing practices.
• Keep abreast of Medicaid and Medicare billing issues that could affect dental billing.
• Other job duties as assigned by the Billing Manager.

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education/Experience: Certificate or diploma in Insurance Billing and Coding an accredited institution; or a minimum of five (5) years direct ambulatory or community health billing related experience and/or training; or equivalent combination of education and experience.