Dental Billing Specialist

Riverland Community Health is a Federally-Qualified Health Center in St. Paul, where patients receive community-based Family Practice medical care in addition to mental health, dentistry, social work and other integrated services. When joining RCH, you become part of a diverse, inclusive, and welcoming team who are dedicated to serving our patients and pursuing our mission to deliver excellent healthcare for all and training for the providers of tomorrow.

JOB SUMMARY:

The Dental Billing Specialist manages the claims process, including accurate and timely claim creation, follow-up and correspondence with providers, insurance inquiries/correspondence. This position is responsible for assisting in the clarification and development of process improvements and inquiries; and assuring payments related to patient services from all sources are recorded and reconciled timely in order to maximize revenues. Other important duties include credentialing, enrollment processing, and reporting. The Dental Billing Specialist performs clinical support services and assigned related work such as adding liaison from dental department to patients and patient services, under the direct supervision of the Revenue Cycle Manager.

ESSENTIAL FUNCTIONS:

Administrative Duties:

• Prepare and submit clean claims to third party payers either electronically or by paper.
• Coordinate the process of patient eligibility through various third-party sources.
• Maintain assigned Work Queues (WQ)
• Ensure Medicare Federal Qualified Health Center (FQHC) billing is correct.
• Denial and insurance follow-up management.
• Issue adjusted, corrected, and/or rebilled claims to third party payers.
• Collect/Add information for Workers’ compensation and motor vehicle claims.
• Accept/Run the weekly statement batch.
• Assist in setting up payment plans with patients.
• Request insurance and patient refund.
• Maintain strictest confidentiality; adheres to all HIPAA guidelines/regulations
• Report concerns/issues to Revenue Cycle Manager.

Customer Service:

• Answer phone call from patients and insurance companies.
• Return message left on the after-hours Business Office line.
• Explain benefits to patients.
• Respond to patient’s inquiry on why insurance did not pay.
• Correspond with and provide updates to insurances.
• Identify and resolve patient billing problems.
• Take patients ‘credit card payments over the phone.

Perform other tasks as assigned.