[ref. b39880921] Dental Biller
Metro Community Health Center Pittsburgh
Dental Biller
ESSENTIAL FUNCTIONS:
- Responsible for daily billing operations to ensure maximum productivity, accuracy of claims submission and third party follow up through automated work queues while assisting with resolution of disputed claims.
- Maintains a good working knowledge of the specific billing requirements for all payers for FQHC.
- Including assigning appropriate DPT-4 codes and appropriate ICD- 10-CM diagnosis codes selecting the codes that accurately describe the condition for which the service or procedure was performed.
- Provides ongoing training and development of staff as required to ensure payor requirements are met.
- Review claims editing reports for consistent errors and follow up with the management for improvement in quality and performance.
- Analyze and trend billing issues related to A/R, i.e., Specialty, Payer, Provider, etc. for efficiencies while taking proactive approach to resolve A/R issues prior to escalation.
- Engage in open communication with management regarding information system, third party payor, and regulatory updates and/or enhancements.
- Contacts patients to obtain, verify, and update account information when necessary
- Work with the payors and subscribers to resolve issues and facilitate prompt payment of claims.
- Develop and analyze reports that will monitor claim edit trends
- Ability to work independently, with minimal supervision. Must be very reliable and punctual as attendance is important for this position
- Participate in review and evaluation of claim denials to ensure appropriate reimbursement.
- Participate in assessing claim edits to enhance the billing system functionality and identify user training and development needs.
- Process monthly patient statements and answer patient inquiries in regard to those statements.
- Generate patient service invoices in a timely manner.
- Being familiar with the responsibilities of Patient Access and willing to perform such duties on a daily basis up to but not limited to answering patient calls, scheduling, insurance verification and prior authorizations.
- The list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities that management may deem necessary from time to time.
- High school graduate or equivalent, bachelor's degree preferred.
- Must be knowledgeable of medical and dental terminology, electronic and manual claims processing, and third-party payor billing guidelines and reimbursement practices for primary care centers.
- Must be able to establish priorities, effectively problem solve, and use good judgment and decision making in day-to-day billing operations and work independently.
- Must have ability to communicate well both orally and in writing. Requires prior working experience on personal computers and various office equipment.
PI7d68ca613b66-37156-35357837
Butler (PA), 35 mi from Pittsburgh
monitoring; Meals on Wheels; rehabilitation services and private duty.
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