UNIV - Dental Billing Specialist - College of Dental Medicine

Medical University of South Carolina•Charleston, SC

20h•$46,206 - $78,540

About The Position

The Dental Billing Specialist supports billing and revenue cycle operations for the College of Dental Medicine. The role is responsible for billing, coding and modifier review, claims processing, payment posting and reconciliation, accounts receivable management, insurance follow-up, patient account resolution, payment plan administration, and related activities. The position supports accurate and timely reimbursement through claim review and submission, denial management, account reconciliation, charge review, compliance-focused auditing, and communication with patients, providers, staff, students, and third-party payers. The specialist reviews charges and modifiers, researches and corrects billing and coding issues, audits accounts and charts, posts and reconciles payments, maintains payment plans, and processes claim corrections, reconsiderations, appeals, and resubmissions. The role also responds to billing inquiries, follows up on unpaid or disputed claims, resolves payment and account discrepancies, verifies insurance information, maintains accurate records, prepares reports, and assists with complex account matters. The specialist serves as a resource on billing and coding procedures, provides customer service, and participates in projects, process improvement, workflow development, and training.

Requirements

High school diploma.
Three years of professional experience in a related area such as accounting, auditing, finance, or commercial lending.
Computer literacy.
A bachelor's degree with multiple accounting courses may substitute for two years of the required work experience.

Responsibilities

Review charges in Charge Review and Modifier Review work queues for coding, modifier, documentation, and billing issues that could affect claims and reimbursement.
Research and correct claim, charge, coding, and modifier errors using clinical documentation, EHR records, payer responses, and account activity.
Perform account and chart audits to verify coding accuracy, balances, claim integrity, and supporting documentation.
Post and reconcile insurance and patient payments, electronic remittances, and paper explanations of benefits.
Establish, monitor, and maintain eligible patient payment plans in accordance with MUSC and CDM policies.
Process claim corrections, reconsiderations, appeals, and resubmissions, and provide supporting documentation when appropriate.
Respond to patients and responsible parties about account balances, billing, insurance claims, payments, and payment arrangements.
Respond to patient MyChart messages and Secure Chat requests from CDM faculty, staff, and students concerning billing and patient accounts.
Monitor accounts receivable and follow up on unpaid, denied, underpaid, rejected, and aging claims.
Research claims processed incorrectly as out-of-network and work with participating insurance carriers to request correction or reprocessing when appropriate.
Research missing insurance payments and remittances and follow up to ensure payments are identified, posted, and reconciled.
Identify third-party payer payments, research deposited funds, and coordinate transfer or correction of misapplied or misplaced payments.
Review and process paper and electronic correspondence requiring billing, payment, or claims follow-up, and document actions in patient accounts.
Research and resolve credit balances, unapplied payments, and overpayments; process appropriate refunds in accordance with MUSC and applicable State policies.
Maintain complete and accurate billing, payment, claim, and accounts receivable records.
Identify recurring account, denial, reimbursement, or collection trends and escalate significant concerns to leadership.
Correct patient demographic, guarantor, coverage, and insurance information in the EHR when needed to support accurate billing and claim adjudication.
Perform insurance verification and identify eligibility, coverage, coordination-of-benefits, or other discrepancies requiring resolution.
Communicate with CDM faculty, residents, staff, and students about billing, insurance, and patient account issues.
Prepare routine and ad hoc reports concerning missing charges, charge review, unapproved charges, payment activity, accounts receivable, and billing trends.
Assist leadership with escalated and complex patient account matters by researching account history, claims, payments, adjustments, and documentation, and coordinating resolution.
Serve as a resource and point of contact for CDM faculty, staff, and students regarding coding, billing, patient accounts, and related policies and procedures.
Provide guidance and support regarding billing and coding processes, account resolution, and applicable CDM/MUSC procedures.
Provide professional and courteous customer service to patients, responsible parties, payers, faculty, staff, and students.
Participate in assigned special projects, process-improvement initiatives, workflow development, and training activities.
Perform other duties as assigned.