Dental Billing Specialist

**JOB SUMMARY** The Billing Specialist is responsible for all aspects of dental claims. The Billing Specialist, a key position in the Revenue Cycle, facilitates the claims process, including accurate and timely claim creation, follow-up and correspondence with providers, insurance inquiries and patients. The incumbent will assist in the clarification and development of process improvements and inquiries to maximize revenues. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements for this job description are not intended to be all inclusive. They represent typical elements considered necessary to successfully perform the job. **REPORTING RELATIONSHIPS** The position reports to the Revenue Cycle Manager. No staff report to this position. This position is required to be on-site. **JOB DUTIES AND ESSENTIAL FUNCTIONS** - Prepares and submits clean claims to third party payers electronically, or via the payer portal - Follows dental billing guidelines and legal requirements to ensure compliance with federal and state regulations - Respond to inquiries from patients, payers, providers, and/or other staff as requested - Identifies and resolves patient/insurance billing issues - Work closely with team members regarding claim appeals, denials, resolution, and education - Performs and monitors all steps in the billing processes to ensure maximum reimbursement from patients, government, and commercial payers as well as from special billing arrangements - Understands Medicare, Dental Medicaid and Commercial Dental Payer rules and regulations applicable to billing and coding. Updates business office staff, clinics, patients, and faculty of changes as appropriate - Responsible for ensuring all new providers are oriented to coding, billing, and documentation compliance - Responsible for the continuing billing and documentation education for all providers and residents - Use online healthcare databases and other resources for verification and claim status - Deliver the highest quality service to internal and external customers - Assist other members of the team with projects as needed - Maintains strict confidentiality; adheres to all HIPAA guidelines/regulations - Other duties as assigned by management - Adhere to the Mission and Values of MNHC **QUALIFICATIONS** - High School Diploma/GED - Minimum 3 years dental billing experience - Must have strong knowledge of all guidelines for ICD-10, CDT codes, dental terminology, dental procedures and dental billing processes - Knowledge of Dental Billing/EHR (Electronic Health Records) systems preferably Epic - Knowledge of Dental Reimbursements with knowledge of and EOBs, EFTs and ERAs - Knowledge of Microsoft Office software - Must be focused, self-directed, organized, and have demonstrated problem-solving abilities - Accurate and precise attention to detail - Excellent verbal and written communication skills - Able to work both independently and as part of a team - Must possess team leadership skills and have a positive disposition - FQHC Dental Billing experience will be given special consideration **CERTIFICATIONS** - Certification in Dental Billing and Coding from AAPC - ADA Dental Coding Certificate - Membership in American Dental Coders Association preferred - Certified Dental Billing Specialist (CDBS) highly preferred - Certified Dental Coader (CDC) highly preferred **PHYSICAL DEMANDS:** The physical demands described herein are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation will be provided to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to stand, walk, talk, and hear, use hands to finger, handle or feel. The employee is occasionally required to stoop, kneel, crouch or crawl. The employee is frequently required…