Billing Specialist

Overview Summary: Under the general supervision of the Administrative Coordinator and Practice Manager, and according to established guidelines, ensures accurate assignment of diagnostic, service and procedures coding of dental patient encounters. Qualitatively analyzes dental records to assign CDT codes within Brown University Health standards. Functions as a coding/billing resource to department staff. Researches and reconciles coding errors or omissions. Brown University Health emphasizes Compassion, Accountability, Respect, and Excellence, guiding actions with patients, customers and one another. The organization also expects employees to demonstrate core Success Factors: Instill Trust and Value Differences, Patient and Community Focus, and Collaborate. Responsibilities Review dental record documents and patient encounter forms to identify and assign appropriate diagnosis and procedure codes. Reference appropriate coding manuals to ensure accurate assignment of billing codes. Apply sequencing guidelines to coded data according to established coding protocols and in compliance with AHIMA’s Code of Ethics, CMS directives, and ADA guidelines. Contact dentists and other health care professionals to obtain or clarify missing or ambiguous information in the record. Enter coding/billing information into the Dentrix computerized billing system; create paper invoices as necessary. Review related revenue reports to reconcile charges on patient ledgers against reported data; research and reconcile missing charges or corrections in the billing system. Interact with patients and Patient Financial Services to resolve billing issues, including denials. Perform regular audits to ensure documentation supports payor reimbursement policies and governmental regulations, including Medicare/CMS guidelines. Review electronic dental records to assess documentation adequacy for principal diagnoses, principal procedures, complications, co-morbid conditions, secondary diagnoses and procedures to support coding accuracy. Report inconsistencies in documentation to the Administrative Coordinator. Serve as a resource to department staff for questions related to coding and billing; stay informed on outpatient compliance and reimbursement policies and medical necessity and coding issues. Refer more complex questions to the Administrative Coordinator. Qualifications High School Diploma or equivalent; training in CDT coding, anatomy, physiology, and dental terminology. Experience with dental software (preferably Dentrix). Demonstrated knowledge of PC skills in Windows environment and familiarity with medical/dental billing routines; strong customer service skills and courteous telephone technique. Interpersonal skills to communicate factual information with patients and outside agencies with cultural sensitivity and professionalism. Two years of related experience coding and billing using dental billing software, with demonstrated accuracy in code assignment. Supervisory Responsibility None. Pay Range: $22.04-$36.37 EEO Statement: Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment. Location: Rhode Island Hospital - 593 Eddy Street, Providence, Rhode Island 02903 Work Type: M-F 8:00am-4:30pm Work Shift: Day Daily Hours: 8 hours Driving Required: No #J-18808-Ljbffr