Dental Billing Clerk

Job Description

Job Description

Key Responsibilities: Medi-Cal (Denti-Cal) Billing – Primary Focus: - Prepare, review, and submit dental claims in accordance with Denti-Cal/Medi-Cal guidelines. - Ensure proper use of CDT codes, modifiers, and treatment authorizations (TARs). - Verify eligibility and benefits prior to claim submission. - Monitor claim status and resolve denials, including documentation and X-ray requirements. EHR Review & Documentation Validation: - Review patient charts to ensure billed procedures are supported by documentation. - Verify required X-rays (bitewings, periapical, panoramic) are present and compliant. - Confirm procedure notes, tooth numbers, surfaces, and clinical justification. - Coordinate corrections with providers prior to submission. Commercial Billing: - Submit claims to commercial carriers and manage coordination of benefits. - Post payments and identify denial trends. Accounts Receivable: - Work A/R reports and follow up on unpaid claims. - Correct and resubmit claims as needed. Compliance: - Maintain compliance with HRSA, CMS, DHCS, and HIPAA requirements. - Support audits and ensure documentation integrity. Collaboration: - Communicate with providers and staff regarding documentation issues. - Assist with training and workflow improvements.Desired Qualifications:o High School Graduate and/or billing certificateo Type 35-45 wpm & Computer skillso Customer services experienceo Bilingual Spanish preferredo Strong organizational skillsMust be a team playerBenefits:401(k)Dental insuranceFlexible spending accountHealth insuranceLife insurancePaid time offVision insurance$ 21 per hrSchedule:8 hour shiftDay shiftMonday to FridayAbility to commute/relocate:Atwater, CA 95301: Reliably commute or planning to relocate before starting work (Required)Work Location: In person