Billing and Insurance Speclialist
Job Description
Job Description
Core Responsibilities
- Insurance Management:
- Verify patient insurance eligibility, co-pays, deductibles, and plan limitations before appointments.
- Submit insurance claims accurately and follow up on outstanding, denied, or underpaid claims.
- Prepare and submit pre-authorizations for treatment.
- Submit appeals and corrected claims with necessary supporting documentation.
- Billing and Collections:
- Post insurance payments, patient payments, and adjustments to patient accounts.
- Prepare and send patient statements for outstanding balances.
- Manage the accounts receivable (AR) aging report to ensure timely collection.
- Make collection calls and arrange payment schedules with patients.
- Patient Communication:
- Explain insurance coverage, limitations, and treatment estimates to patients.
- Resolve billing inquiries and discrepancies.
Required Skills and Qualifications
- Technical Proficiency: Knowledge of dental practice management software, dental billing codes, and terminology.
- Communication: Strong verbal and written communication skills to interact with patients and insurance carriers effectively.
- Analytical Skills: Ability to work with numbers, analyze financial data, and identify discrepancies in ledger balances.
- Compliance: Strict adherence to HIPAA regulations and documentation protocols.
- Experience: Often requires a high school diploma or GED, along with experience in clerical or medical billing roles
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