Billing and Insurance Speclialist

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