Dental Biller

METRO COMMUNITY HEALTH CENTER • Pittsburgh, PA

9d

About The Position

Metro Community Health Center extends great benefits to our eligible employees. MCHC current benefits are: MCHC pays 100% of the employee premium for UPMC Medical, United Concordia dental, STD, LTD Life insurance ($100,000) VBA vision coverage is offered as voluntary coverage that paid for by the employee Medical and Dependent Care FSA and HRA 2 weeks of paid parental leave 20 days (4 weeks) of PTO for your 1st two years 12 paid holidays 401k with a 4% match Competitive Wages ESSENTIAL FUNCTIONS: Responsible for daily billing operations to ensure maximum productivity, accuracy of claims submission and third party follow up through automated work queues while assisting with resolution of disputed claims. Maintains a good working knowledge of the specific billing requirements for all payers for FQHC. Including assigning appropriate DPT-4 codes and appropriate ICD- 10-CM diagnosis codes selecting the codes that accurately describe the condition for which the service or procedure was performed. Provides ongoing training and development of staff as required to ensure payor requirements are met. Review claims editing reports for consistent errors and follow up with the management for improvement in quality and performance. Analyze and trend billing issues related to A/R, i.e., Specialty, Payer, Provider, etc. for efficiencies while taking proactive approach to resolve A/R issues prior to escalation. Engage in open communication with management regarding information system, third party payor, and regulatory updates and/or enhancements. Contacts patients to obtain, verify, and update account information when necessary Work with the payors and subscribers to resolve issues and facilitate prompt payment of claims. Develop and analyze reports that will monitor claim edit trends Ability to work independently, with minimal supervision. Must be very reliable and punctual as attendance is important for this position Participate in review and evaluation of claim denials to ensure appropriate reimbursement. Participate in assessing claim edits to enhance the billing system functionality and identify user training and development needs. Process monthly patient statements and answer patient inquiries in regard to those statements. Generate patient service invoices in a timely manner. Being familiar with the responsibilities of Patient Access and willing to perform such duties on a daily basis up to but not limited to answering patient calls, scheduling, insurance verification and prior authorizations. The list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities that management may deem necessary from time to time.

Requirements

• High school graduate or equivalent, bachelor's degree preferred.
• Must be knowledgeable of medical and dental terminology, electronic and manual claims processing, and third-party payor billing guidelines and reimbursement practices for primary care centers.
• Must be able to establish priorities, effectively problem solve, and use good judgment and decision making in day-to-day billing operations and work independently.
• Must have ability to communicate well both orally and in writing.
• Requires prior working experience on personal computers and various office equipment.

Responsibilities

• Responsible for daily billing operations to ensure maximum productivity, accuracy of claims submission and third party follow up through automated work queues while assisting with resolution of disputed claims.
• Maintains a good working knowledge of the specific billing requirements for all payers for FQHC.
• Including assigning appropriate DPT-4 codes and appropriate ICD- 10-CM diagnosis codes selecting the codes that accurately describe the condition for which the service or procedure was performed.
• Provides ongoing training and development of staff as required to ensure payor requirements are met.
• Review claims editing reports for consistent errors and follow up with the management for improvement in quality and performance.
• Analyze and trend billing issues related to A/R, i.e., Specialty, Payer, Provider, etc. for efficiencies while taking proactive approach to resolve A/R issues prior to escalation.
• Engage in open communication with management regarding information system, third party payor, and regulatory updates and/or enhancements.
• Contacts patients to obtain, verify, and update account information when necessary
• Work with the payors and subscribers to resolve issues and facilitate prompt payment of claims.
• Develop and analyze reports that will monitor claim edit trends
• Ability to work independently, with minimal supervision. Must be very reliable and punctual as attendance is important for this position
• Participate in review and evaluation of claim denials to ensure appropriate reimbursement.
• Participate in assessing claim edits to enhance the billing system functionality and identify user training and development needs.
• Process monthly patient statements and answer patient inquiries in regard to those statements.
• Generate patient service invoices in a timely manner.
• Being familiar with the responsibilities of Patient Access and willing to perform such duties on a daily basis up to but not limited to answering patient calls, scheduling, insurance verification and prior authorizations.

Benefits

• MCHC pays 100% of the employee premium for UPMC Medical, United Concordia dental, STD, LTD
• Life insurance ($100,000)
• VBA vision coverage is offered as voluntary coverage that paid for by the employee
• Medical and Dependent Care FSA and HRA
• 2 weeks of paid parental leave
• 20 days (4 weeks) of PTO for your 1st two years
• 12 paid holidays
• 401k with a 4% match
• Competitive Wages

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 11-50 employees