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Billing Specialist - Dental

Escondido, CA
Billing Specialist - Dental
Escondido, CA 92029
$22-$24 per hour DOE

As the Billing Specialist, you will be responsible for all computerized and manual billing to patients and third parties, including Medi-Cal, CHDP, Medicare, private insurances, FamPact, Managed Care plans, and various programs and funding sources as assigned.  In addition, you will be responsible for correct coding processes and compliance measures as set by the organization, department, and industry.

  •  Review of encounters for missing, incomplete, and/or inaccurate information such as coding discrepancies, payer HEDIS needs, eligibility screening and coverage verification as necessary, etc.  
  • Review of progress notes and communication to clinical staff to obtain information required.
  • Claim creation for all billable charges as assigned, with submission of clean claims in compliance with correct coding initiatives and billing industry requirement.
  • Processing and monitoring of system claim status categories assigned to be sure that all transactions are captured for month end close.
  • Register patients as needed.
  • Able to review and process patient eligibility with accuracy, to include acquisition of authorization numbers as necessary.
  • Apply SFS discounts as necessary.
  • Posting of payments as necessary.
  • Account balance adjustments and write offs to resolve accounts as assigned.
  • Monitoring and reporting of trends associated with denials, coding issues, benefit changes, etc.
  • Review and processing of claims aging and denials as assigned to include claim tracers, corrected claim submissions, appeals, and consistent revenue flow.
  • Responsible for back-line phone calls from sites and voicemail associated on a daily basis.
  • Discuss escalated billing inquiries with patients, third party payers, and/or sites to resolve account questions and/or problems.
  • Provide customer service internally and externally with professionalism, courtesy, knowledge, and follow through.
  • Handle Site/Insurance/Patient correspondence, as assigned, received in the department with a sense of urgency and appropriate follow through.
  • Maintaining department productivity, quality, and compliance standards at all times.
  •  Attend educational workshops, staff meetings and clinic in-services as directed.  
  • Function at highest level according to credentials and competency 
  • High School Diploma/ GED required.
  • 2 year of medical billing and follow-up experience with revenue cycle process.
  • Multiple speciality or FQHC environment experience is a plus!
  • Bilingual English/Spanish is preferred.
  • Proficient in CPT, HCPCS, and ICD COdes.
  • Familiar with insurance payers and funding sources to include manage care plans.
  • Proficient in MS Office - Word, Excel, Outlook.
Please submit your resume for consideration!
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