Dental Billing Specialist

Dental Billing Specialist

The purpose of this position is to analyze and evaluate clinical information, review or assign appropriate dental procedure codes, and provide additional information as requested for the purpose of billing professional Dental services.

May include leading project teams and directing others.

Contact with Dental Faculty, HU/HUH Staff, Third Party Payers, and Vendors.

Assures maximization of cash collections through diligent and timely monitoring and management of all open accounts receivable balances.

Reviews dental claims generated by the axiUm system for data accuracy, appropriate coding, and conformity with ADA requirements, ensures timely claim submission to insurance companies on paper and using EDI, and ensures that the third-party contractual agreements are met.

Monitor claim submission and reconcile insurance company checks against submissions.

Researches and resolves submission issues and claim denials, acts as a liaison with third-party carrier professionals regarding reimbursement/ claim denial issues, requests and submits additional documentation/ radiographs as needed, and identifies the root cause of submission issues/denials and implements process and system or policy enhancements to limit issues and denials.

Proactively identifies areas to improve billing and enhance payment at the time of service, actively participates in the implementation of policy and process enhancements, and educates faculty, students, and staff on claim submission guidelines.

Supports and provides guidance to faculty, students, clinic staff, and axiUm system administrators on proper and efficient claim procedures and documentation requirements.

Creates and sends patient statements. Answers patient inquiries.

Creates and analyzes system reports on billing activities and Accounts Receivable and recommends process, system, or report enhancements to more accurately reflect current business practices.

Maintains current, appropriate, and competent knowledge on ADA standards, CDT/codes, CMS policies, and axiUm system modifications to perform job function effectively.

Abide by the Standards of Ethical Coding and Code of Ethics as set forth by the American Health Information Management Association and the American Association of Professional Coders, respectively.

Performs data entry and other duties assigned.

Must keep abreast of ADA coding principles and guidelines. Ability to understand, interpret, and apply clinical information from the ADA Regulations and other sources for accurate code assignment.

Naturally inquisitive, proactively investigates, identifies, and communicates issues, facilitates issue resolution, and follows through on solution implementation.

Must possess excellent analytical, problem-solving, and organizational skills. Ability to be detail-oriented, establish priorities, and meet deadlines where demands of a diverse nature are involved.

Adaptable to new technology. Proficient in Microsoft Word and Excel, as well as the use of standard office equipment.

Demonstrated effective time management skills to prioritize tasks, meet deadlines, and react to workflow and process issues.

Superior communications skills, written and verbal. Must be able to communicate and professionally provide feedback, and be mentally adaptable and flexible in dealing with a variety of people. Ability to use good judgment, make sound decisions, and behave with tact, decorum, and diplomacy.

Must be able to follow and understand instructions and react favorably in all work situations.

Ability to work in a team environment and maintain a harmonious working relationship with staff, students, faculty, University officials, and the general public.

Prefer an Associate's Degree or equivalent from a 2-year college or completion of a certified coding program and 2-3 years related experience – will consider applicants with relevant experience and minimum 2-3 years CPT or CDT coding experience.

Understands dental billing and reimbursement, including industry standard billing rules, Medicare, Medicaid, and commercial insurance

Demonstrated fluency in CDT (preferred) or CPT coding and documentation standards and ability to code accurately and apply ADA and CDT coding guidelines.

Certified Coding Specialist (CCS) or Certified Professional Coder (CPC); or Certified Coding Associate (CCA) preferred.

Exceptional communication and organizational skills. Some presentation skills are preferred, as well as conflict resolution and demonstrated problem-solving techniques, a plus.

Strong skills in Microsoft Office, specifically Excel and Word;

Knowledge of efficient billing processes and documentation guidelines with some auditing skills.

Compliance Salary Range Disclosure

Expected Pay Range: $43,641 - $48,006