Dental Insurance Verification & Billing Specialist

Job Summary:
We are seeking a highly organized and detail-oriented Dental Insurance Verification and Billing Specialist to join our dental practice. The ideal candidate will be responsible for verifying patients' insurance coverage and submitting accurate claims to insurance providers for payment.

Key Responsibilities:

Verify patient insurance coverage and benefits prior to appointments
Obtain and update patient insurance information in the practice management system
Calculate and estimate patients' out-of-pocket expenses and inform them of their financial responsibilities prior to their appointments
Submit accurate and complete insurance claims to insurance providers
Monitor outstanding insurance claims and follow up with insurance providers for payment
Research and resolve insurance claim issues and denials
Generate and review patient account statements for accuracy
Provide excellent customer service to patients regarding insurance and billing questions
Collaborate with the dental team to ensure the smooth flow of patient care and billing procedures

Additional Responsibilities:

Create Initial Claim & Continuation of Treatment -
As a patient begins treatment, ensure all procedure codes are entered correctly,
and if there are any UCR charges, verify they are entered in as well. And to make things
even easier, generate the initial claim and set up a “continuation of treatment” claim, too.

Benefit Verification & Eligibility -
Verifying eligibility and the patient’s benefits. Entering benefit information on the patient’s account and insurance ledger, and then noting any benefit ---------- ticing any benefit exceptions and rectifying them with the patient
and then re-verify them so that treatment can begin without any issues.

Process Claims -
Process claims, to make sure everything is correct by first previewing batch
claims for any missing information. Then, batch and transmit the claims and send out
transmission and rejection reports daily. After that, enter any comments
or discussions with the patient and their insurance company so office is kept aware of any
and all communications. Finally, post the insurance checks received for practice
management ---------- ll On Past Due Claims -
Running reports and calling carriers for past due amounts. For accounts over 60 days past due, we call on the 2nd
business day. For accounts 30 days past due, we call on the 18th of the month. Then, we note
all exceptions on the account. Lastly, make any adjustments needed, whether it’s an aging account, future billings, frequency or transfers.

Monthly Claim Reporting -
Monthly claim reporting. Making sure accounts with insurance balances and
banding dates with no claim are on our radar. We also provide a continuation
report as well as ensuring you’re aware of accounts with a positive insurance balance, but
credits in aging. Our claim reporting also includes accounts with a zero-insurance balance, but
have months remaining and need a continuation. We even send out continuing treatment letters / vouchers to carriers for you. Review accounts for credit balances, notifying you so that you can process or issue an insurance refund if
needed.

Qualifications:

High school diploma or equivalent
Minimum of 2 years of experience in dental insurance verification and billing
Proficient in using practice management software and dental insurance portals
Knowledge of dental terminology and procedures
Excellent organizational and communication skills
Strong attention to detail and ability to multitask in a fast-paced environment
Ability to work independently and as part of a team
Experience with handling patient financial information in a confidential manner
Knowledge of CDT codes and dental insurance billing requirements