Dental Billing Specialist - Grace Health

Must have 1 year dental billing experience in the last 3 years!
Summary: 

This position is responsible for the dental financial processes including utilization of dental portals, obtaining eligibility and benefits, calculating, and communicating patient estimates, reviewing provider charges and insurance, making corrections as needed, adding modifiers, and processing provider charges from the Holding Tank, tasking providers with clarifying questions or notification of un-submitted charges, and providing support to the billing company as needed with A/R follow-up.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Understand functions within the Practice Management system of Nextgen including batch posting, holding tank, charge screen, and work log. Understand functions of Electronic Dental Record (EDR).

• Review dental schedules and obtains Eligibility and Benefits and financial estimates for patients.

• Review treatment plans tasked from the provider, check E & B, obtain financial responsibility and Prior Auth as required

• Communicate financial responsibility and payment expectations with the patient

• Schedule appointments

• Take patient payments

• Review and Process Dental Charges from the Holding Tank; ensure Dental Hygienist Visits are auto adjusted for services provided at a SBH clinics. 

• Complete understanding of the Sliding Fee Discount Program, talk with patients about qualifications and financial obligations.

• Work Log follow up for claim prod errors, medical records and authorization requests, coding errors, credentialing issues, COB etc.  Trends should be identified and shared with appropriate leadership so pertinent information can be shared or changes can be made to reduce future denials.

• Appropriate referral to staff who can make adjustments.

• Help answer Customer billing questions as needed and refer questions to Leadership as indicated.

• Work with each Dentist office to reconcile invoices for SBHC services and send to the Dir. of Finance for processing.

• Regularly work the Denial Report and alert leadership of Credentialing, KY Wrap, Timeliness or any other trends that need addressed. Follow up on Dental encounters sent in the Work Log from RCM.

OTHER ESSENTIAL DUTIES and RESPONSIBILITIES:

• Grace Health recognizes that managing patient care is a team effort that involves clinical and non-clinical staff.  All employees must embrace a team-based approach to patient care and understand that each role is important to our success. 
• Team members must demonstrate excellent team communication and coordination to provide quality patient care.
• Care coordination includes communicating with community organizations, health plans, facilities, and specialists.
• Care team members understand and embrace the concept of population management and proactively address the needs of patients and families served by this practice. 
• Team members must demonstrate skill and knowledge related to effective communication with vulnerable patient populations.
• Team members must participate in Continuous Quality Improvement activities within the organization to ensure patients receive high quality care.
• All team members will be involved in the process of improving quality incomes.
• Team members will participate in the review and evaluation processes of practice performance and help to identify opportunities for improvement.
• Team members will participate in Grace Health's advocacy program.

GENERAL DUTIES:

• Follows policies and procedures of the office, including administrative, clinical, quality assurance, and personnel
• Maintain good attendance (daily, meetings, and other assignment tasks)
• Maintain timely documentation of all work assignments
• Maintain patient confidentiality
• Routinely keep supervisor informed about attendance and job assignments
• Flexible in being able to multitask
• Work effectively and at an efficient pace
• Work cooperatively with physicians, administration, and peers

QUALIFICATION REQUIREMENTS:

 To perform this job successfully, an individual must be able to assist in advancing Grace Health’s mission and to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

SKILLS:

• Pleasant personality and professional demeanor
• Cooperative attitude-Flexible
• Detail Oriented
• Effective written and oral communication skills
• Highly organized work habits with ability to prioritize
• Intermediate computer skills with Microsoft Word and Excel
• Familiar with Electronic Medical Record

EDUCATION and/or EXPERIENCE: 

Must have completed high school.
Minimum of 1 year of Dental Office Billing Experience is Required

BENEFITS:

• Safe harbor 401(k) with match potential
• Paid time off
• Family friendly work environment
• Health insurance
  • Wellness program
  • Health savings account
  • Pharmacy benefit
  • Employee visits for medical services
• Dental insurance
• Vision insurance
• Life Insurance
• STD/LTD
• EAP & Work life services
• Voluntary benefits
• Hospital indemnity

Grace Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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