Dental Care Coordinator and Billing Specialist - Guadalupe, AZ

Dental Care Coordinator And Billing Specialist

We are looking for a meticulous and organized Dental Care Coordinator and Billing Specialist who effectively captures the dual responsibilities for managing patient care and handling billing processes. The ideal candidate will be a healthcare professional who manages the billing and collections processes, ensuring accuracy and efficiency in handling patient accounts and insurance claims. They will also be responsible for managing and coordinating questions about larger treatment plans or referrals to specialists that the patient may have.

Principle Duties and Responsibilities

1. Billing and Claims Management:

• Prepare, submit, and track dental insurance claims.
• Monitor and ensure timely payments from insurance companies.
• Review and appeal unpaid or denied claims.
• Generate and issue invoices to patients

2. Patient Account Management:

• Maintain accurate patient billing records.
• Respond to patient inquiries regarding billing and payment procedures.
• Identify and resolve patient billing complaints.
• Process refunds to patients and insurance companies.

3. Insurance Coordination:

• Verify patient insurance coverage and benefits
• Liase with insurance providers to clarify patient coverage and resolve disputes.
• Stay updated with current dental terminology, coding, and insurance regulations.
• Credentialing new providers with insurance companies.

4. Administrative Duties:

• Perform data entry and reporting tasks.
• Collaborate with dental office staff to maintain accurate patient records.
• Auditing to ensure patient information remains confidential and up to date.

5. Coordinating Patient Care:

• Develop and manage individualized care plans
• Schedule appointments
• Ensure timely follow ups
• Point of contact for provider/patient updates

6. Patient Education:

• Educate patients and approved family members about dental conditions, treatment plans, and available resources.

7. Qualifications:

• High school diploma or equivalent; additional education, certification in medical or dental insurance courses, dental assisting license, and radiology certification
• Prior experience as a medical or dental biller
• Familiarity with RPMS, CDT, and ICT coding
• Excellent organizational skills and attention to detail
• Interpersonal skills including excellent dental communications and strong writing skills for insurance claim correction/appeals and patient treatment plan presentations
• Ability to work with sensitive patient information while maintaining confidentiality

Additional Focus Area Duties and Responsibilities:

1. Occasional coverage for the Patient Support Service Technician:

• Patient interactions: Greet patients, answering patient phone calls, and respond to inquiries
• Appointment Management: Schedule and confirm patient appointments manage the dentist's schedule.
• Manage Patient Records: Maintain and update patient records, ensure confidentiality and accuracy.
• Administration Tasks: Manage office supplies, sort mail, and ensure reception area is clean and welcoming. Scheduling of patients with appropriate timeframes and providers.

Required Knowledge, Skills, and Abilities

Knowledge of:

• Clerical and office support practices.
• Assigned department operations and functions.
• Customer services principles and practices
• Assigned department operations
• English language, grammar, and punctuation
• Tracking and reporting software, electronic systems for processing third party insurance billing, AHCCCS eligibility and enrollment requirements, RPMS, and Practice Management.
• Dental Terminology and Procedures: Familiarity with common dental procedures and terminology.
• More extensive mathematical concepts and ability to read budget sheets
• Filing procedures and practices
• Insurance Policies and Protocols: Understanding different dental insurances and credentialing process
• Proficiency with billing software
• CDT and ICD codes HCFA 1500s and UB-92
• How to audit for appropriate procedure and code
• Dental Insurance process and procedure
• Radiology identification for insurance claims
• HIPAA regulations
• Yaqui culture, customs, resources, and traditions and/or a willingness to learn.

Skills and Abilities:

• Maintaining files and records
• Must be able to prepare a variety of correspondence, records, reports, documents, and forms
• Follow oral and written instructions, policies, and procedures, operate a variety of office equipment, including a computer, fax, adding machine, and related software application
• Ability to manage multiple patients accounts, track payments, and handle billing cycles efficiently
• Attention to detail: ensuring accuracy in billing, coding, and claim submission to avoid errors and denials as well as audits of providers procedures.
• Operate a variety of office equipment, including a computer and related software applications.
• Good communication and interpersonal skills as applied to interaction with co-workers, supervisor, management, Council members, and the public. Have ability to sufficiently exchange or convey information and receive verbal and written work instructions.
• Customer Service: providing support and resolving billing issues for members
• Problem-Solving: Ability to identify and resolve billing issues, including denied claims
• Time Management: Efficiently managing time to handle billing tasks, follow-ups, and administrative duties
• Analytical Skills: analyzing billing data and financial reports to ensure accuracy and compliant
• Adaptability: staying updated with changes in billing regulations and software updates.
• Interpersonal skills including excellent dental communications and strong writing skills for insurance claim correction/appeals and patient treatment plan presentations
• Ability to work with sensitive patient information while maintaining confidentiality

Education, Certifications and Experience Required

High school diploma or equivalent; additional education, certification in medical or dental insurance courses

• Dental Assisting Certificate
• Radiology certification
• 5 years of experience performing dental billing and insurance claims
• Training with RPMS, CDT, and ICT coding

Special Requirements:

• Must possess and maintain a valid Arizona Driver's License.
• Must have a current Level 1 Arizona Clearance Card or be able to obtain one within ninety (90) days of hire. Failure to maintain a current Level 1 Clearance Card will result in termination