Dental Billing Specialist

Lynn Community Health Center•Lynn, MA

5d•$22 - $30

About The Position

Reporting to the Direct Supervisor, the Dental Billing Specialist is responsible for billing and fiscal operations of the Dental program. The position reviews patient ledger charges and insurance eligibility, submits claims, posts and reconciles receipts, follows up on denied and unpaid claims, prepares adjustments and month-end reports, and maintains patient confidentiality. The specialist also provides billing guidance to providers and fiscal staff, gathers audit documentation, and completes related duties as assigned.

Requirements

History of good attendance and a positive work attitude.
College degree or equivalent bookkeeping or billing experience.
Computer proficiency.
Knowledge of professional office practices.
Comfort working in a medical or dental environment and ability to maintain strict confidentiality.
Excellent communication skills, professional demeanor, and good judgment.
Ability to work autonomously, conscientiously, and proactively.

Nice To Haves

Prior experience in a dental or medical office.
Understanding of Medicaid and Free Care health insurance plans.
Bilingual proficiency in Spanish or Khmer and English.

Responsibilities

Review charges posted to patient ledgers, including the use of ADA codes appropriate to each dental carrier.
Review patient eligibility before claims are sent, including running REVS, contacting managed care and state organizations, and reconciling enrollment from third-party payors such as PACE and SCO.
Instruct and review with providers, the Practice Manager, and Controller any monthly errors or omissions related to ledger charges.
Keep current with billing practice changes initiated by insurance carriers and state agencies.
Determine which carrier claims should be sent and provide reporting with documented reconciliation of charges.
Send claims to carriers and/or patients by paper or electronic methods.
Post cash receipts from self-pay patients and insurance carriers.
Reconcile the cash receipts journal at month-end and fully explain any variances.
Prepare monthly HSN, insurance, bad debt, suspended credit, and refund adjustments.
Research denials, make appropriate corrections, and resubmit claims in a timely manner.
Follow up on claims listed in the monthly unpaid claims report and return the report to the Controller with the status of each claim and actions taken.
Analyze and follow up on unpaid claims, including recommendations for bad debt and other write-offs.
Analyze the appropriateness of, and post, entries in patient accounts.
Generate, review, and submit month-end reports.
Perform related duties such as filing, scanning, setting up patient financial plans, gathering audit documentation, and assisting other staff when needed.
Maintain patient confidentiality.
Collect and analyze data as needed.
Provide a weekly status report to the Direct Supervisor.
Work autonomously, conscientiously, and proactively.
Perform additional related duties and special assignments as directed by the supervisor.