Orthodontic Medicaid Specialist - Rock Dental Brands

Rock Dental•Little Rock, AR

8d•Onsite

About The Position

Rock Dental Brands is seeking a talented and self-motivated Orthodontic Medicaid Specialist to manage and oversee the Medicaid accounts receivable (A/R) lifecycle for their dental clinics. This role focuses on prior authorization submission and reconsideration, following up on payment denials, managing appeals, and ensuring accurate payment posting to optimize reimbursement. The company emphasizes a passion for their work and a commitment to customer focus, offering a career that impacts lives by creating smiles.

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 orthodontic 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.