Job Information
Community Clinic Inc. Dental Biller in Silver Spring, Maryland
CCI Health Services’ mission is to deliver high quality, accessible care to our community members, leading the way to a more equitable health care system for everyone.
POSITION SUMMARY: The Dental Biller at CCI is responsible for the accurate and timely filing of all dental insurance claims, payments, denials, and appeals. This position monitors patient accounts, collects and posts payments from insurance companies and provides information to patients as needed. The dental biller will be responsible for monthly dental claim reporting and will assist with dental prior authorizations as needed.
DUTIES & RESPONSIBILITIES
Review coding to ensure the correct procedure codes and information is completed.
Follow up with dentists and dental staff as needed to ensure all patient visit documentation is completed before sending claims.
Process dental claims to appropriate primary, secondary, and/or tertiary insurance company according to insurance guidelines.
Accurate and timely review, reconcile, and post patient and insurance payments, both by EFT and check.
Daily electronic claims follow up and submission of all x-rays, periodontal charting or documentation requested from the insurance companies.
Resolve claim denials with insurance and resubmit as appropriate including any requested information.
File appeals necessary on all denied or outstanding claims.
Working with payers to resolve claim issues
Actively reviewing claims rejection reports and correcting any issues
Actively work any insurance denials or no pays
Researching outstanding claims >30 days in a timely manner
Reviewing claims submission for accuracy
Monitor the Accounts Receivable, which includes collecting any patient balances and assigning any accounts to the collection agency as needed.
Review patient accounts for accuracy and completeness before sending patient monthly statements.
Ensure that insurance pre-authorizations are received prior to service provision.
Provide daily, monthly, or as needed dental reports as requested.
Assist in credentialing or recredentialing dental providers as needed.
Correct account set up errors (guarantor, demographics, insurances, etc.).
Ensure that all dental insurance plan coverages are updated in the practice management system
Daily - Reviewing insurance benefits for accuracy
Assisting and fee schedule updates
Swiftly documenting self-reporting on incorrect insurance payments
Submitting refunds request for any payments made in error
Submitting corrective claims for any incorrect procedures rendered
Evaluates patient financial status and established budget payment plans or eligibility for Sliding Scale consideration.
Must ensure open and constructive coordination with health center personnel in maintaining accuracy in data elements and processing crucial to effective claims processing and account resolution.
Must ensure adherence with all HIPAA Regulations and Compliance Regulations ensuring the protection of PHI (Patient Health Information).
MINIMUM QUALIFICATIONS:
Minimum High School diploma, an AA or BS degree preferred or commensurate experience.
Must have at least 2 years of relevant work experience in a dental office managing insurance claims, reimbursement and patient accounts.
DENTAL experience REQUIRED!!!
Strong attention to detail.
Must be familiar with dental coding an billing.
Strong customer service skills - bilingual (English/Spanish) is a plus.
Must be assertive and goal oriented.
Familiarity with computerized systems is required.
Must be a willing participant in ongoing educational activities and a contributing participant in staff meetings
* CCI Health Services is an Equal Opportunity Employer *
Founded in 1972, CCI Health Services is a diverse and inclusive workplace grounded in community. Located in the Washington, DC Metro Area, each year CCI cares for more than 60,000 individuals in Montgomery and Prince George’s Counties. As a non-profit, CCI is committed to improving health equity through the provision of affordable primary care for all, across all stages of life. Visit ccicares.org for more information.
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