Claims Coordinator

CarolinasDentist • Raleigh, NC

100d • $18 - $24

About The Position

The Claims Coordinator ensures accuracy and timely filing for all dental claims for assigned office and reports problems and issues on follow up report to dental office. Reviews Accounts Receivable reports on assigned rotation for all offices, following up on outstanding insurance claims and balances; working problem EOBs, denials, and processing appeals as needed.

Requirements

• Previous experience in dental office administration, dental billing, or insurance claims processing is highly beneficial
• Familiarity with dental terminology and procedures is essential for accurately processing claims and communicating with dental providers and insurance companies
• A good understanding of dental insurance policies, coverage limitations, and claim submission procedures is necessary
• Knowledge of common insurance codes (e.g., CDT codes) and claim forms (e.g., ADA dental claim form)
• Detail-oriented to accurately review claims and identify discrepancies or errors
• Strong communication skills for interacting with patients, dental providers, insurance companies, and other staff members
• Ability to effectively manage and prioritize multiple tasks
• Proficiency with dental practice management software and other computer applications used for claim processing and administrative tasks
• Good customer service skills for addressing inquiries and concerns in a professional and empathetic manner
• Ability to troubleshoot issues related to claim processing, billing errors, or insurance coverage discrepancies
• Knowledge of and adherence to legal and ethical guidelines related to patient privacy (HIPAA) and billing practices

Responsibilities

• Reviews clinical note, x-rays, and account ledger for cohesion of information
• Creates and submits e-claims and paper claims, this includes ortho claims
• Sends claims through clearing house and manages all invalid and rejected claims
• Ensures claims are sent out within 48 hours of the date of service
• Includes any account or claim issues on a Follow Up report to the dental office or assigns to the designated clinical team member within PMS with the expectation that answers and corrections will be made within 48 hours of sending the report
• If accounts are unresolved from the dental office from the follow up report, sends an Urgent Weekly Report to the dental office
• Files corrected claims triaged from the AR Specialist based on returned problem EOBs
• Manages Accounts Receivable report on an assigned schedule, reviewing accounts for outstanding insurance claims and balances
• Calls and follows up with insurance companies on claims issues and non-payments
• Maintains and completes all appeals and requests from insurance companies
• Reviews returned EOBs for denials and manages info needed for appealing claims
• Tracks all outstanding insurance balances by category and reports to OM when completed
• Participates in special projects and tasks as assigned
• Fills in for other Claims Coordinators as needed
• Assists and conducts training of new CC RCT members
• Attends and contributes to monthly meetings
• Reports to CD-RCM with any grievances or issues

Benefits

• Health and dental benefits
• 401(k)
• Holiday pay
• Paid time off

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Number of Employees: 11-50 employees