Insurance Billing & Collections Specialist

Overview

Smile Brands is one of the nation's largest dental support organizations (DSO), and we are seeking a detail-oriented Insurance Billing & Collections Specialist to support insurance accounts receivable operations in San Antonio, TX. This role is responsible for claim follow-up, denial resolution, appeals, aging account management, and payment reconciliation across multiple dental practices. The ideal candidate will possess a strong understanding of dental insurance processes, explanation of benefits (EOBs), timely filing requirements, payer follow-up, and accounts receivable best practices, along with the ability to work efficiently in a fast-paced revenue cycle environment.

In this role, you will be expected to manage assigned inventory productively, maintain accurate and thorough documentation, meet follow-up timeliness standards, and contribute to reducing aging balances and preventable denials while supporting a positive patient and payer experience.

This is a full-time, on-site role. Following completion of training, employees who meet performance expectations may be eligible for a hybrid schedule of up to two work-from-home days per week. Hybrid eligibility is performance-based and subject to business needs.

Responsibilities

• Monitor and work assigned insurance accounts receivable to drive timely resolution and maximize reimbursement.
• Follow up with commercial, PPO, Medicaid, and other payers to verify claim status, identify denials, and resolve underpaid, unpaid, zero-paid, and partially paid claims.
• Review explanation of benefits (EOBs), remittance details, and payer correspondence to determine root cause and next steps for account resolution.
• Prepare and submit corrected claims, appeals, claim inquiries, reconsiderations, and required attachments within payer and timely filing guidelines.
• Research and correct account issues including demographics, subscriber data, eligibility, coordination of benefits, plan limitations, missing documentation, and payer-specific billing requirements.
• Audit claims and patient accounts for completeness and accuracy, including narratives, attachments, referral information, and supporting clinical documentation when required.
• Partner with practice teams, internal departments, and payer representatives to resolve claim barriers and reduce avoidable denials.
• Maintain accurate notes, account actions, and follow-up dates in the practice management system to support visibility and continuity of work.
• Track aging trends, escalation items, and payer issues, and communicate opportunities for process improvement to leadership.
• Stay current on payer policies, reimbursement rules, dental coding updates, and revenue cycle best practices relevant to a multi-site DSO environment.

Qualifications

• 2 years of dental insurance collections, dental billing, or revenue cycle management experience
• Working knowledge of dental insurance plans, claim submission workflows, denials management, appeals, EOB interpretation, and timely filing requirements.
• Strong attention to detail, organization, follow-through, and accuracy in documentation.
• Effective verbal and written communication skills with the ability to work collaboratively across teams.
• Comfortable navigating practice management systems, payer portals, and Microsoft Office applications, especially Excel.