Job Description

Job Description

Job Description

Position Purpose:

The Dental Billing Coordinator will ensure the efficient and accurate processing of dental insurance claims and billing procedures within our dental practice. This position requires a detail-oriented individual with a strong understanding of dental insurance policies, coding procedures, and billing regulations. The Dental Billing Coordinator is responsible for verifying insurance eligibility, submitting claims electronically, and following up on outstanding claims to ensure timely reimbursement. Additionally, they collaborate closely with dental providers, administrative staff, and insurance companies to resolve billing discrepancies and address patient inquiries. The ideal candidate will have a minimum of 5 years of experience in dental billing, with expertise in handling various insurance types including PPOs, HMOs, and Medi-Cal/Dental (Denti-Cal).

Principal Responsibilities:

1. Review third-party payers’ insurance coverage, Sliding Fee Discount Program application, and Patient Responsibility Form for completeness and accuracy.
2. Process dental claims accurately and efficiently, adhering to insurance guidelines and regulations.
3. Verify insurance eligibility and benefits for patients, ensuring accurate billing and timely reimbursement.
4. Familiarity with electronic dental claims submission systems, including proficiency in attaching radiographs, periodontal charting, and narratives as required.
5. Maintain all transactions up to date.
6. Assist patients with questions regarding balances and estimates.
7. Review charges for accuracy to expedite reimbursement. Follow third-party payers’ billing guidelines to maximize payment and data integrity.
8. Work directly with the Clinics’ staff to resolve any billing and coding issues.
9. Monitor claims submissions and correct rejections.
10. Reconcile billed charges and resolve any unbilled claims’ discrepancies. Investigate past due balances and pursue collections.
11. Run daily encounter report for assigned sites - TBD (prefer clinics with commercial dental plans).
12. Work on documentation requests from commercial dental insurance plans.
13. Run dental insurance aging report on a monthly basis and report progress grid to Chief Dental Officer each month.
14. Run encounter listing report at the end of each week and send to Dental Managers with “ccing” Chief Dental Officer.
15. Update monthly Excel sheet of monthly dental revenue pending by payor type and email it to Chief Dental Officer and Dental Managers at the end of each month.
16. Maintain and update list of Dental Insurance Payers overall and by site and distribute it at the start of each year.
17. Request commercial insurance Fee Schedules at the start of each year and email them to Chief Dental Officer and Dental Managers. Also, maintain a binder with the most up-to-date commercial dental insurance fee schedules.
18. Assist Dental Team in closing open encounters and respond to questions promptly.
19. Assist with creating PowerPoints and/or videos for training new Dental Front Office staff regarding billing and collections, Sliding Fee Discount process, workflow under the direction and in collaboration with the Billing Director and Revenue Cycle Manager.
20. Provide a monthly report to Chief Dental Officer regarding Cal-Aim incentive payments.

Skills & Abilities Requirements:

1. Effective written and oral communication.
2. Comprehensive knowledge of dental procedures and CDT Codes.
3. Ability to work with persons from a wide diversity of social, ethnic and economic background.
4. Ability to work creatively with other health care professionals from a variety of disciplines to achieve maximal results for the clinic’s patient, from a system of integrated primary health care.
5. Ability to multitask and prioritize assignments and responsibilities to ensure compliance with established deadlines and protocols.

Physical Requirements:

1. Prolonged sitting or standing may be required. Those physical movements and the degree of mobility, manual dexterity and hand-eye coordination normally associated with dental assisting in specialty and general practice dentistry will be performed on a repetitive basis.
2. May require travel to sites/program and special functions.
3. Work under stressful conditions as well as irregular hours may be required.

Environmental Conditions Critical to Performance:

1. Will be exposed to outside environmental conditions while traveling.

Education and Experience Requirements:

1. Minimum of 5 years of experience in dental billing.
2. Proficiency in handling various insurance types, including PPOs, HMOs, and Medi-Cal Dental (Denti-Cal).
3. Experience working within a Federally Qualified Health Center (FQHC) environment is preferred.
4. High School diploma or GED certificate required.
5. Completion of accredited course in Dental Billing.
6. Bilingual: English /Spanish is required.

*All JWCH, Wesley Health Centers workforce members are recommended to be fully vaccinated against COVID-19.

Employee Benefits

JWCH Institute, Inc., offers competitive salaries for all positions. Employees working 30 hours per week or more are provided a monthly allowance which can be used towards medical, dental, and vision premiums. The agency offers sick leave, vacation time, 13 paid holidays, 401(k) Safe Harbor Profit Sharing plan, mileage reimbursement, short term and long tern disability plans, life insurance policies, employee parking and more !

Wesley Health Centers JWCH Institute is an Equal Opportunity Employer!

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