Job description
ESSENTIAL FUNCTIONS:
- Identifies delinquent accounts, aging periods, and payment resources
- Contacting patients for additional insurance information and resubmitting dental claims to appropriate dental payers.
- Reviewing Explanation of Benefits and patient history for accurate reimbursement and discounts by contracted managed care companies.
- Research and processes all rejected claims and resubmits with corrected information.
- Assists with processing insurance & patient refunds.
- Processes insurance related correspondence and responding timely to inquiries.
- Follow up with insurance companies ensuring that claims are paid on a timely basis by monitoring aging reports and open claims reports.
- Develops relationships with key personnel at the dental payers to obtain assistance with claim reconsiderations.
- Maintains strict confidentiality
- Performs all other duties as assigned
QUALIFICATIONS:
- Knowledgeable with Dental Coding
- Knowledgeable with Dental Medicaid and PPO claim adjudication
- Knowledgeable with Dental Benefits and Verification of Coverages
- Knowledge of legal and regulatory provisions related to collection activities.
- Skilled with computer applications and fast typing.
- Ability to communicate with internal operations, patients, and insurance companies on all collection matters in a courteous manner.
- This position may require the employee to use his/her personal vehicle to travel to different work sites during the course of the work day, which means you would need an active, valid Driver’s License.
PHYSICAL REQUIREMENTS:
- Prolonged sitting and standing as needed
- Ability to lift up to 15 lbs
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