Responsibilities
- Verify patient insurance coverage and benefits through provider portals and outbound calls.
- Confirm patient eligibility, coverage limits, and treatment authorizations.
- Ensure accurate and up-to-date insurance information is recorded in the patient management system.
- Submit dental claims to insurance companies and follow up on unpaid or denied claims.
- Calculate patient copays, co-insurances, and deductibles based on insurance coverage.
- Communicate financial responsibilities to patients and provide clear explanations of their bills.
- Assist patients with understanding their insurance benefits and payment options.
- Post insurance payments and patient payments accurately into the billing system.
- Reconcile payments with patient accounts and ensure that all transactions are properly documented.
- Act as a liaison between the dental office, insurance companies, and patients to resolve billing issues and answer questions.
- Maintain organized and accurate billing records and documentation.
- Ensure compliance with legal and regulatory requirements related to billing and patient information.
- Prepare and analyze billing reports to identify trends, issues, and opportunities for improvement.
- Assist in developing and implementing billing policies and procedures to enhance efficiency and accuracy.
Qualifications
- Clear and coherent in both written and verbal communication skills to effectively interact with patients, insurance companies, and team members.
- Proven experience managing multiple responsibilities simultaneously in a fast-paced environment.
- A team player with ability and willingness to work with a diverse staff and customers.
- Knowledge in reviewing and submitting claims.
- Strong understanding of the claims process, including reviewing claim submissions for accuracy, following up on unpaid or denied claims, and ensuring timely submission of claims to insurance companies.
- Familiarity with common dental procedures and terminology helps in correctly interpreting and coding services provided.
- Ability to use basic Microsoft Excel functions and formulas to organize and analyze data relevant to billing and claims processing.
- Strong critical-thinking skills with the capability to analyze billing issues, identify discrepancies, and make informed decisions to resolve problems.
Screening Criteria
- At least one (1) year experience in dental billing.
- At least six (6) months to 1 year experience in calling insurance companies.
- At least six (6) months to 1 year experience in insurance verification.
- Must have a stable employment history
