Dental Claims Processor

Oklahoma City Indian Clinic•Oklahoma City, OK

3d•Onsite

About The Position

Oklahoma City Indian Clinic (OKCIC) is a non-profit corporation that provides culturally sensitive health care to the American Indian population. OKCIC services include not only basic medical care but also dental, optometry, behavioral health, fitness, nutrition, and other family programs. Our mission is to provide excellent healthcare to American Indians. We do this by putting people first, providing quality services, and maintaining our Integrity and Professionalism. We are looking to add compassionate team players to our growing team as we continue to work toward our goal of becoming the national model for American Indian Health Care. Oklahoma City Indian Clinic is hiring a Dental Claims Processor for our Dental team! This position will process and submit dental claims for adjudication and payment, ensuring claims are accurate, complete, and submitted within required timely filing deadlines. The Dental Claims Processor will submit HIPAA-compliant claim batches to Medicare, Medicaid, and commercial insurers, create and process claims in Dentrix and EDS, and follow up on invalid claims. This position will investigate questionable claims and services with certified coders, make necessary corrections to claims, and answer claims-related questions as needed. Applicants claiming Indian Preference must complete the full application and must provide documentation verifying eligibility (such as a tribal enrollment card or Certificate of Degree of Indian Blood (CDIB)).

Requirements

Must align with OKCIC vision, mission, and core values.
High school diploma or GED
Two (2) years of experience in dental billing.
Knowledge of Medicare, Medicaid, and commercial dental insurance plans.
Knowledge of ICD-10, CPT, and CDT codes.
Ability to use claims clearinghouse software and EDS.

Responsibilities

Submit HIPAA-compliant claim batches to Medicare, Medicaid, and commercial insurers.
Follow up on invalid claims in EDS and utilize the invalid claims report to make necessary corrections.
Create and process claims in Dentrix and EDS.
Create claims to meet timely filing requirements.
Submit and follow up on HIPAA-compliant claims.
Investigate questionable claims and services in collaboration with certified coders.
Answer phone calls regarding claims questions as needed.
Thoroughly review claims to ensure there is no missing or incomplete information.
Participate in required training and educational activities necessary to fulfill departmental goals.
Research training opportunities related to the dental billing office to remain current on billing practices and coding changes and submit training recommendations to the Dental Director for approval.