Billing Specialist
Denton, TX • Billing
**NO EXPERIENCE REQUIRED**
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POSITION SUMMARY
The Billing Specialist posts payments received from insurance companies, cash payments and payment plans to patient’s accounts; enters adjustments, write offs and reconciles patient’s accounts. The Billing Specialist reviews claims for non- payment, posts the zero payment to the patient’s account and writes off the unpaid procedures and claims; resubmits claims with corrected codes, submits secondary claims and mails statements for co-pays and balances due on the account. The Billing Specialist works reports; processes refunds and check requests; does account clean up, and serves as a resource to the dental practices to help improve billing processes and accuracy.
QUALIFICATIONS
Education: High School graduate or equivalent preferred.
Experience: A minimum of six (6) months experience in a health care collections or related field, or any combination of education, training, or experience in a health care business office environment. Experience with insurance billing, computer and business software programs preferred.
Licensure: n/a
Additional Requirements: May be required to work flexible hours and occasional overtime.
PRIMARY RESPONSIBILITIES
THE ESSENTIAL JOB FUNCTIONS OF THE POSITION
- Post Cash payments, primary & secondary insurance payments and Payment Plans
- Secondary Insurance Payment
- Post Zero Pays
- Write-off unpaid claims
- Resubmit claims with corrected codes
- Mail Secondary Claims
- Mail Statements for Co-pays and Patient Balances
- Clean-up accounts
- Process Insurance Refund Requests for overpayment
- Process Check Refund Requests from Patients
- Work Reports
- Assists dental offices with any patient / insurance payment questions
- Achieve departmental goals for accurately submitting both paper and electronic insurance claims for previous day’s treatment
- Determine if claims need to be submitted electronically or via paper and send all supporting documentation
- Correct and send rejected claims
- Contact dental offices for information necessary to send a claim
- Assists dental offices with claim submission questions
- Verify all demographic (spelling of names, date of birth, and insurance carrier) information is correct.
- Correct insurance and demographic information if incorrect and resubmit a corrected claim within 95 days from DOS.
- Work weekly reports
- Adheres to company, department, corporate, personnel and standard policies and procedures.
- Attend all mandatory company in-services and staff development activities as scheduled.
- Adhere to company standards concerning conduct, dress, attendance and punctuality.
- Support company-wide quality/performance improvement goals and objectives.
- Maintain confidentiality of company employees and patient information.
- Perform other duties as assigned
Note: The essential job functions of this position are not limited to the duties listed above.
KNOWLEDGE, SKILLS, AND MENTAL APTITUDE
- Knowledge of coding and billing procedures.
- Knowledge of computer software applications.
- Knowledge of insurance billing and collection procedures.
- Skill in organizing and prioritizing workloads to meet deadlines.
- Skill in telephone etiquette.
- Effective oral and written communication skills.
- Ability to communicate effectively with patients and co-workers.
- Ability to adhere to safety policies and procedures.
- Ability to use good judgement and to maintain confidentiality of information.
- Ability to work as a team player.
- Ability to demonstrate tact, resourcefulness, patience and dedication.
- Ability to accept direction and adhere to policies and procedures.
- Ability to work in a fast-paced environment.
- Ability to react calmly and effectively in emergency situations.
- Ability to meet corporate deadlines.
PHYSICAL, MENTAL, AND SPECIAL DEMANDS
- Ability to work a 40 hour week.
- Ability to sit for long periods, up to 8 hours.
- Ability to use both hands in fine manipulation of small tools (copier, computer, telephone, typewriter, calculator, safe, facsimile machine).
- Ability to push and pull up to 10 lbs. (file cabinet drawers, computer paper boxes).
- Ability to see well enough to read handwritten and typewritten material.
- Ability to lift and carry up to 25 pounds to move file boxes and data processing paper.
- Ability to retrieve files from bottom shelves and drawers and move boxes of paper and forms to the computer printer.
- Ability to reach, turn and twist above and below the waist daily to retrieve files.
- Ability to spend 90% working time in an environment of continuous low voices and office machine noise typical for business office atmosphere.
- Ability to handle a variety of repetitive tasks.
MACHINES, TOOLS, EQUIPMENT, AND OTHER WORK AIDES
- Copy machine
- Computer and various software packages
- Calculator/10-Key
- Facsimile machine
- Postage meter
- Policies and procedure manuals
Job Type: Full-time
Pay: $14/hr (based on experience)
Internal ID: CDP100