UNIV - Dental Billing Specialist - College of Dental Medicine

About the role

The Billing Specialist will primarily focus on payor reimbursement, Accounts Receivable, denial management, recognize potential high-risk accounts, and develop techniques to improve collections and streamline processes. Will pursue resolution for all patient issues regarding patient accounts. Review/analyze patient accounts and take the necessary steps to resolve patient/guarantor issues. Assist with escalated/high priority account issues. Provide customer service as needed.

Responsibilities

• Accurately bill BCBS of SC, Medicaid, self-pay/uninsured, accepted federal grant programs, and commercial dental insurance, processing claims in accordance with payer requirements and organization policy
• Regularly audit claims and EHR documentation for accuracy and Federal, State, and facility policy compliance
• Aid member clients filing claims for non-accepted plans in compliance with CDM MUSC policies
• Post and allocate payments, electronic remits, and paper explanation of benefits (EOBs)
• Submit pre-treatment estimates according to CDM MUSC policy and upon member client request
• Process fee adjustment request according to CDM MUSC policies
• Correct claim and charge errors; audit for verification which includes but is not limited to audit of coding, payments, and EHR to identify and rectify any missing or incorrect charges
• Correct transaction entry errors within EHR
• Provide Efficient and effective account receivable services on behalf of our member clients to maximize reimbursement and support CDM revenue cycle performance
• Aid with the collections of receivables for guarantor and any third-party payers by monitoring accounts receivables, checking claim status and resubmitting claims of overdue accounts, filing corrected claims or appeals and alerting supervisor of seriously overdue accounts and trends
• Identify and address significantly overdue accounts according to state and facility policies
• Issue correspondence related to balances, including patient account statements
• Thoroughly research and resolve credit balances
• Process refunds according to CDM MUSC and SC State policies
• Perform deposit reconciliation for all of CDM MUSC deposits according to separation of duties
• Answer phone calls from patient and responsible parties regarding account balances and/or other account related matters
• Maintain complete and accurate billing and accounts receivable records
• Act as a point of contact and resource for CDM Faculty, Staff and Students for coding and accounting questions, assistance with accounts, and policy questions
• Special projects as needed

Requirements

• A high school diploma and three years professional experience in a related area such as accounting, auditing, finance or commercial lending
• A bachelor's degree with multiple accounting courses may be substituted for two years of the required work experience

Qualifications

• Ability to perform job functions in an upright position
• Ability to perform job functions in a seated position
• Ability to perform job functions while walking/mobile
• Ability to work indoors
• Ability to perform repetitive motions with hands/wrists/elbows and shoulders
• Ability to reach in all directions
• Possess good finger dexterity
• Ability to maintain tactile sensory functions
• Ability to lift and carry up to 15 lbs., unassisted
• Ability to lift objects, up to 15 lbs., from floor level to height of 36 inches, unassisted
• Ability to lower objects, up to 15 lbs., from height of 36 inches to floor level, unassisted
• Ability to push/pull objects, up to 15 lbs., unassisted
• Ability to maintain 20/40 vision, corrected
• Ability to see and recognize objects close at hand
• Ability to see and recognize objects at a distance
• Ability to match or discriminate between colors
• Ability to determine distance/relationship between objects; depth perception
• Good peripheral vision capabilities
• Ability to hear and/or understand conversations
• Ability to perform gross motor functions with frequent fine motor movements

Skills

• Computer literacy

Benefits

Not specified

Pay

$45,300.00 - $61,100.00 - $77,000.000

Schedule

40