Review and follow up on outstanding claims to ensure timely reimbursement
Investigate claim denials, determine reasons for non-payment, and follow up with the payer to resolve and appeal when necessary
Oversee billing activities, ensuring accurate and timely submission of claims to payers, and address any billing discrepancies
Identify, investigate, and resolve claim rejections promptly to ensure the timely processing of payments
Provide support and respond to internal and external inquiries regarding billing issues, claim statuses, and account discrepancies
Manage follow-up on outstanding accounts receivable, ensuring timely resolution of overdue claims and facilitating effective communication with payers
Accurately post payments and adjustments to patient accounts and insurance claims
Identify and resolve credit balances on accounts, ensuring they are handled promptly and according to company policy
Assist in identifying and implementing process improvements to streamline the AR and billing functions
Work closely with other members of the RCM team to ensure timely and effective resolution of claims, share knowledge on payer issues, and improve overall processes

High school diploma or equivalent
Minimum of 3 years of experience in accounts receivable, dental billing, or a related field
Experience in a dental or healthcare environment, ideally within a Dental Service Organization (DSO) or similar multi-location setting
Strong knowledge of insurance billing, payment procedures, and AR processes
Knowledge of payer guidelines and claims appeals processes
Familiarity with dental practice management systems, such as Dentrix or similar PMS platforms
Ability to navigate payer portals, insurance company websites, and databases
Excellent communication and negotiation skills to resolve issues with insurance payers
Strong attention to detail and organizational skills.

Front and Back-End Specialist

Key skills