Medical Billing Specialist

GENERAL SUMMARY OF DUTIES: 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).

SUPERVISION EXERCISED:  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.