Insurance and Billing Specialist Position Summary
The Insurance and Billing Specialist is responsible for managing patient accounts, maximizing insurance reimbursement, and ensuring timely collection of outstanding balances. This role requires strong knowledge of dental insurance, excellent communication skills, and attention to detail to maintain accurate patient accounts and support the financial health of the practice.
Key Responsibilities
- Conduct routine audits of patient accounts to ensure billing accuracy and account integrity.
- Review insurance claims for accuracy and follow up on unpaid, denied, or delayed claims.
- Contact dental insurance companies to verify benefits, obtain claim status updates, and resolve payment discrepancies.
- Submit corrected claims, appeals, and supporting documentation when necessary.
- Contact patients regarding outstanding balances and collect payments in a professional and courteous manner.
- Establish and manage payment plans for patients while maintaining compliance with office financial policies.
- Monitor accounts receivable and identify overdue accounts requiring follow-up.
- Coordinate collection efforts and prepare delinquent accounts for referral to a third-party collections agency when appropriate.
- Document all patient and insurance communications accurately in the practice management software.
- Verify insurance eligibility and benefits as needed.
- Reconcile insurance payments, adjustments, and patient balances.
- Work closely with providers and the front office team to resolve billing and insurance issues.
- Maintain compliance with HIPAA and all applicable insurance billing regulations.
- Assist with month-end reporting, aging reports, and other financial audits as assigned.
Qualifications
- Minimum of 5 years of dental insurance and billing experience preferred.
- Strong understanding of PPO, Medicaid, and commercial dental insurance plans.
- Experience with dental practice management software (Dentrix preferred).
- Knowledge of CDT coding, insurance claim submission, and accounts receivable management.
- Excellent organizational, analytical, and problem-solving skills.
- Strong verbal and written communication skills.
- Ability to manage multiple priorities while maintaining accuracy and confidentiality.
Preferred Skills
- Experience appealing insurance claim denials.
- Knowledge of payment processing and patient financing options.
- Strong customer service and conflict-resolution skills.
- Ability to work independently while collaborating effectively with the dental team.
- Proficiency in Microsoft Office and electronic billing systems.
Pay: $25.00 - $30.00 per hour
Work Location: In person
