Dental Claims Specialist

Cambridge Dental Group•Dearborn Heights, MI

59d•Onsite

About The Position

Cambridge Dental Group is seeking a detail-oriented and experienced CBO Team Member to join our centralized business office team. This role is essential in ensuring accurate and timely submission and follow-up of Medicaid pre-authorizations and claims. The ideal candidate will bring a strong background in Medicaid billing and revenue cycle management (RCM), with a commitment to accuracy and efficiency.

Requirements

5+ years of Medicaid billing and RCM experience (preferred)
Proven ability to manage pre-authorizations and claims efficiently
High attention to detail and task-focused work style
Strong organizational and follow-up skills
High school diploma or equivalent required.
Three years healthcare cash posting, billing, third party follow-up and collections experience required; OR a combination of education and/or experience in business or related field totaling three years.
Knowledge of automated business applications, including word-processing, spreadsheet and data base management applications required.
Data entry experience and knowledge of Medicare, Medicaid, and third-party insurance preferred.

Nice To Haves

Some dental clinical experience (helpful but not required)

Responsibilities

Submit all Medicaid pre-authorizations and claims in a timely manner.
Follow up consistently on pre-authorizations and claims to ensure proper resolution.
Review and manage daily work logs to resolve outstanding claims.
Appropriately document all account activities within the practice management system.
Process EOB and R/A payments/denials accurately and promptly.
Communicate effectively with leadership, co-workers, and dental offices regarding claim status.
Maintain a high level of accuracy and attention to detail in all job functions.
Provide backup support to other CBO team members as needed.