Our client - a healthcare facility in Trenton, is seeking a Dental Biller/Coder. With a focus on detail and accuracy, the Dental Biller/Coder will work to ensure the timely coding and billing of dental provider encounters for submission to insurance companies. The Dental Biller/Coder will also work with the Dental Coding Specialist to research and resolve billing issues. This is a temp-to-hire position.
• Ensure all the insurance information is entered correctly into Dentrix.
• Maintain, verify and audit Dentrix insurance companies and also dental claims.
• Works closely with Finance Department, Medical/Dental Coding Specialist, ABW and Provider Enrollment Specialist to establish priorities in duties/responsibilities.
• Accesses the Electronic Health System, Athena and Dentrix, daily, to retrieve, review, and accurately code or correct dental providers coding on billing encounters according to ICD10 guidelines while following insurance requirements to maximize reimbursement.
• Daily review and weekly review of patient accounts for appropriate billing distribution, error codes, and missed information.
• Communicates immediately with the dental provider to clarify any incomplete or unclear documentation.
• Ensures services are billed to the appropriate insurance or other revenue source for that date of service.
• Communicates immediately with Patient Access or insurances using various means to confirm or clarify coverage.
• Makes recommendations for documentation improvements to maximize reimbursement.
• Responds to the billing vendor for coding clarification requests produced by insurance denials.
• Contacts and works with patients to resolve insurance related billing issues.
• Works with the Patient Access department and Dental Manager to resolve billing and registration issues.
• Maintaining current insurance practices, requirements, and forms; verifying proper reimbursement is received for services provided; processing and following up insurance claims; and documenting and coding information, interpreting medical records.
• Reviewing patient accounts and determining appropriate billing distributions; processing statements and entering information into database; and reviewing past due bills and following up on past due accounts. Performs all related work as required.
• Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.
EDUCATION & EXPERIENCE:
• High School Diploma required, some College preferred.
• Coding experience in primary care setting preferred.
• Prior billing experience (1 year min.) with an understanding of dental insurances ie; Medicare, Medicaid, Managed Care, and Commercial insurances, and a thorough understanding of dental insurance billing basics, ie; charges, allowed amounts, payments, adjustments, denials, capitation, eligibility, coordination of benefits.
• Experience preferred with all aspects of revenue, understanding the lingo on explanation of benefits and having payment posting experience; experience in dealing with insurance companies and being able to work around their stall tactics and get claims paid; customer service skills in talking with patients about their accounts
• Certified Professional Coder (CPC) Preferred
• Computer literacy including proficiency in Microsoft Word and Excel
• Ability to use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
• Bilingual preferred
• Ability to work well with others and to assist the public and other staff members cooperatively and courteously.
• Must be detail oriented with strong organizational and analytical skills
• Excellent communication and interpersonal skills.
• Ability to complete projects timely and accurately critical.
• Ability to convey information effectively.
• Strong initiative and ability to manage multiple projects as well as strong follow through skills
• Recognize and respect cultural diversity.
• Team work and collaboration
• Meets dress code standards; appearance is neat and clean.
• Actively participates in performance improvement and continuous quality improvement (CQI) activities.
• Understands all aspects of revenue, as well as the lingo on explanation of benefits and having payment posting experience; experience in dealing with insurance companies and being able to work around their stall tactics and get claims paid; customer service skills in talking with patients about their accounts.08618