Dental Medicaid Specialist - Rock Dental Brands

Rock Dental Brands•Little Rock, AR

2d•Onsite

About The Position

Rock Dental Brands has an exciting opportunity for a talented and self-motivated individual to become a member of our team. The Dental Medicaid Specialist is responsible for managing and overseeing the Medicaid accounts receivable (A/R) lifecycle for our dental clinics. This role specializes in handling the prior authorization submission and reconsideration process, aggressively following up on payment denials, managing complex appeals, and ensuring accurate payment posting to optimize reimbursement.

Requirements

Experience with dental Medicaid billing, prior authorizations, and the appeals process.
Strong knowledge of dental terminology and CDT coding as it relates to Medicaid requirements.
Proficient in practice management softwares and insurance portals
Excellent analytical and problem-solving skills with high attention to detail.
Operational excellence in Medicaid A/R management.
Accountability and self-motivation.
High focus on payer portal management and clinical documentation standards.

Responsibilities

Manage the end-to-end prior authorization process for Medicaid dental procedures, including accurate submission of clinical documentation and follow-ups.
Proactively monitor and resolve Medicaid claim denials by performing root cause analysis and submitting timely appeals.
Perform daily follow-ups on unpaid or underpaid Medicaid claims and utilize payer portals (e.g., MMIS, Atrezzo) to check claim status and verify eligibility.
Maintain detailed, accurate documentation in practice management software for all A/R activities and appeal statuses.
Conduct internal audits to ensure billing accuracy, maintain strict adherence to Medicaid compliance standards, and support compliance and revenue integrity projects to identify and resolve recurring financial issues.
Collaborate with clinic staff to provide feedback on billing errors and audit A/R aging reports to identify trends in denials.