Overview:
Summary
The Orthodontic Accounts Receivable (AR) Specialist is responsible for the timely and accurate
execution of insurance claims processing, patient AR follow-up, and resolution of account balances. This
position is focused on task-level support for collections, including reviewing EOBs, submitting appeals,
correcting billing errors, and contacting payers and patients. The AR Specialist plays a key role in
maintaining clean claims, minimizing aging AR, and supporting revenue cycle team goals through
dependable daily follow-up activities.
Essential Responsibilities
- Reads/analyzes Explanations of Benefits (EOBs) for accuracy; determines appropriate follow-up
actions.
- Submits dental claims, appeals, and supporting documentation to payers.
- Identifies and corrects billing errors and resubmits claims as needed.
- Conducts root cause research for denied or unpaid claims.
- Uses insurance portals and phone outreach to follow up on claim status.
- Bills work-in-progress, secondary and tertiary insurance when applicable.
- Reviews remittance advice for underpayments or payment discrepancies.
- Escalates recurring payer issues or delays to supervisors as needed.
- Initiates & maintains patient AR follow-up for overdue balances, per internal protocols.
- Coordinates payment arrangements or flag accounts for further collection activity.
- Conducts ledger audits, contract corrections, and AR adjustments with policy alignment.
- Responds to practice-level inquiries via email or ticketing system in a timely and professional
manner.
- Supports Cloud9 optimization and contribute feedback to improve workflows.
- Meets assigned productivity benchmarks and team performance goals.
- Expected to work all scheduled days and hours, and to report to work on time.
- Embraces NADG’s values, culture, and “Core 3”: People First, Access to Care, and Cost
Containment.
- Supports the NADG Care Cycle and prioritizes delivering best-in-class patient care.
- Other duties as assigned.
Experience/Requirements
- Minimum of 2 years in dental revenue cycle, including claims billing and patient collections.
- Proficiency in Microsoft Office Suite.
- Familiarity with insurance portals and eligibility/claim inquiry tools.
- Knowledge of insurance payer guidelines and AR workflows.
- Experience with Cloud 9 or other orthodontic software preferred.
Knowledge, Skills, and Abilities (KSAs)
- Attendance & Reliability: Arrives to work on time; dependable, punctual, and demonstrates strong
time management skills.
Cooperation & Teamwork: Works respectfully and effectively with colleagues; contributes
meaningfully to help the practice achieve its goals.
- Communication Skills: Demonstrates clear, organized, and effective written and oral
communication; exhibits strong listening and comprehension abilities.
- Customer Service: Provides professional, helpful, and high-quality service to both internal and
external customers, addressing patient needs effectively.
- Leadership & Decision-Making: Makes thoughtful, well-reasoned decisions; demonstrates
resourcefulness and creativity in problem-solving.
- Initiative & Flexibility: Takes initiative by seeking additional responsibilities; identifies problems
and proposes solutions; adapts well to new challenges and unexpected changes.
- Knowledge & Expertise: Possesses a strong understanding of the information, processes, and
procedures necessary to perform the role effectively.
- Technical Capabilities: Performs job responsibilities with attention to detail, consistency,
productivity, and efficiency, in alignment with company and industry standards.
- Digital Dentistry: Demonstrates knowledge of digital equipment and software used in the practice,
including Open Dental, Primescan, Overjet, and others.
Education/Certifications
- High school diploma or equivalent
- Additional education or certifications in billing/coding preferred.
Physical/Environmental
- This is a sedentary role, requiring prolonged periods of sitting and regular use of a computer and
other standard office equipment.
- Requires frequent talking, hearing, and visual acuity for computer work and communication.
- May occasionally be required to lift items weighing up to 30 pounds.
- Work is performed in a private home office environment.
- Occasional travel may be required.
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