Billing & Denial Specialist Job at MAHEC
PRIMARY ACCOUNTABILITY:
Manage daily billing functions for assigned patient insurance companies. Coordinate the interaction between patients and payors to facilitate timely reimbursement. Serve as a point of contact for billing problem solving. In depth knowledge of carrier Clinical Coverage Policies (CCP) and Billing Coverage Policies (BCP). Dental knowledge essential. Dentrix knowledge beneficial.
SPECIFIC RESPONSIBILITIES:
- Maintain Accounts Receivable KPI (A/R balances older than 120 days must be less than 19% of total A/R)
- Maintain Adjusted Collection Percentage KPI (Reimbursement/Collections equal to or above 97% of Expected)
- Review and resolve denied patient insurance claims
- Assist in identifying current and/or potential billing issues specific to unpaid claims
- Post and balance all activity from carrier remits to include payments, contractual adjustments, and other adjustments
- Post and balance all payments from patients
- Make appropriate decisions and calls to carriers to maximize reimbursement on accounts to be worked
- Correct errors on electronic error reports
- Process and print/transmit patient insurance claims, bills and other reports.
- Respond to patient account inquiries in person, by phone, or by mail; resolve problems as necessary
- Respond to inquires from office staff regarding patient charges, appropriate
- diagnosis coding, and insurance coverage related issues
- Respond to inquiries from employees, payers, and patients regarding CPT and ICD-10 codes
- Maintain high level of patient confidentiality
- Ensure compliance with HIPAA regulations
- Other duties as assigned
This job description is a general description of the essential job functions. It is not intended to describe all the duties a Billing Coordinator may perform.
EDUCATION and/or EXPERIENCE:
Associate Degree in Business, Health Administration, or a related field, three (3) years relevant experience in dental, or a comparable combination of education and/or experience required.
COMPUTER SKILLS:
Must have the ability to use/learn Allscripts products, Microsoft Word & Excel, and various insurance company websites; previous experience preferred.
COMMUNICATION SKILLS:
Must have excellent written and oral communications skills
FOREIGN LANGUAGE SKILLS:
Spanish-speaking skills preferred.
PHYSICAL DEMANDS:
Frequently sits, uses hands and arms to reach and work on computer, talks, and listens. Occasionally walks. Sometimes stands, climbs, or kneels.
Sometimes lifts up to 50 pounds.
Vision required, as related to computer use.
WORK ENVIRONMENT:
Sometimes works near moving mechanical parts and in warm office conditions.
Moderate noise level, typical of a busy office environment with office equipment and light foot traffic.
ADDITIONAL INFORMATION:
- Ability to perform duties with speed and accuracy
- Ability to think strategically
- Ability to work independently and to initiate and complete tasks with minimal supervision required
- Ability to coordinate tasks within the department, the division, the organization, and the local, regional, and national payor community
- May serve as point person for contacts from within as well as outside of the department
- Must maintain high level proficiency in Excel with moderate to high level of proficiency in Word
- Must demonstrate appropriate service orientation in all interactions within the organization and with clients, patients and visitors.
- Must be a team player.
- Must demonstrate discretion in dealing with medical, fiscal and personnel information as is appropriate to position.
- Requires the ability to appropriately and professionally handle multiple and competing priorities.
REPORTING RELATIONSHIP: Reports directly to the Business Office Manager.
Throughout the COVID-19 pandemic, MAHEC has worked tirelessly to promote evidence-based practices across our entire organization. With this in mind, all MAHEC employees and learners will be required to receive the COVID-19 vaccine or have an approved exemption.
MAHEC Talent Management is located at 121 Hendersonville Road, Asheville, NC 28803. Equal Opportunity Employer. Black, Indigenous, People of Color and Spanish/English bilingual persons are strongly encouraged to apply.
With this in mind, studies show that women, gender diverse, and BIPOC candidates are less likely to apply unless they meet all of the qualifications listed in the job description.
If you are interested in this role, and you have related experience and qualifications, we encourage you to apply or reach out to
AskTalent@mahec.net
for support in your job search process. You could be the talent we are seeking for this or other opportunities.
MAHEC is a certified Living Wage employer through Just Economics of Western North Carolina. We offer excellent benefits and are committed to creating a diverse, inclusive, and equitable workplace.
Starting wage for this position is $18.32/hour and offer is based on experience, educational requirements and internal team equity.
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