UNIV - Dental Billing Specialist - College of Dental Medicine

Medical University of South Carolina•Charleston, SC

About The Position

The Billing Specialist will primarily focus on payor reimbursement, Accounts Receivable, denial management, recognize potential high-risk accounts, and develop techniques to improve collections and streamline processes. Will pursue resolution for all patient issues regarding patient accounts. Review/analyze patient accounts and take the necessary steps to resolve patient/guarantor issues. Assist with escalated/high priority account issues. Provide customer service as needed. The College of Dental Medicine (CDM) MUSC billing team member will manage collection issues with CDM Leadership, resolve issues, apply new information to future collection issues, and make suggestions to enhance our efficiency and effectiveness through process improvement. Act as a point of contact and resource for CDM Faculty, Residents and Staff for coding and accounting questions, assistance with accounts, and policy questions. Provide teaching and guidance for CDM students regarding patient coding, patient estimate and account management and financial treatment plans. Establish and maintain positive working relationships with patients, payers, team members, and clients. Maintain confidentiality of patient information, organization data and information always in compliance with HIPAA regulations.

Requirements

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

Responsibilities

Accurately bill BCBS of SC, Medicaid, self-pay/uninsured, accepted federal grant programs, and commercial dental insurance, processing claims in accordance with payer requirements and organization policy
Regularly audit claims and EHR documentation for accuracy and Federal, State, and facility policy compliance
Aid member clients filing claims for non-accepted plans in compliance with CDM MUSC policies.
Post and allocate payments, electronic remits, and paper explanation of benefits (EOBs).
Submit pre-treatment estimates according to CDM MUSC policy and upon member client request
Provide treatment plan and estimated cost review upon request
Process fee adjustment request according to CDM MUSC policies
Correct claim and charge errors; audit for verification which includes but is not limited to audit of coding, payments, and EHR to identify and rectify any missing or incorrect charges.
Correct transaction entry errors within EHR
Provide Efficient and effective account receivable services on behalf of our member clients to maximize reimbursement and support CDM revenue cycle performance
Assist with the collections of receivables for guarantor and any third-party payers by monitoring accounts receivables, checking claim status and resubmitting claims of overdue accounts, filing corrected claims or appeals and alerting supervisor of seriously overdue accounts and trends.
Identify and address significantly overdue accounts according to state and facility policies
Issue correspondence related to balances, including patient account statements
Thoroughly research and resolve credit balances.
Process refunds according to CDM MUSC and SC State policies
Perform deposit reconciliation for all of CDM MUSC deposits according to separation of duties.
Answer phone calls from patient and responsible parties regarding account balances and/or other account related matters.
Maintain complete and accurate billing and accounts receivable records
Timely and accurate communication with CDM Faculty, Residents, Staff and Students in accordance with department processes
Provide regular and Ad Hoc reporting to CDM Leadership for missing charges and unapproved charges / documentation; weekly, monthly, & yearly. Audit when needed to identify trends.
Identify issues, make updates to Insurance background maintenance within EHR, and assist with additional background maintenance tasks as assigned.
Assists supervisor and administration with escalated patient account issues; works quickly, accurately, and professionally to resolve high priority patient accounts
Act as a point of contact and resource for CDM Faculty, Staff and Students for coding and accounting questions, assistance with accounts, and policy questions.
Special projects as needed
Other duties as assigned