Job Details
Level
Experienced
Job Location
FL - Corporate - Tampa, FL
Job Shift
*Full Time
Description
Essential Duties and Responsibilities
• Provide daily oversight, direction, and leadership to the Revenue Assurance Team.
• Monitor revenue assurance activities and processes.
• Open tasks to the dental practices, providing the specific information and/or instruction needed to obtain claim payment.
• Read and analyze explanation of benefits and make proper adjustments according to Coast Dental claims processing criteria.
• Independently assess billing and payment issues by insurance carrier and work to resolve.
• Manage patient statements and answer questions regarding account balances by auditing and making necessary adjustments per request.
• Provide necessary information and documents to 3 rd Party Collection Agency to successfully collect on patient accounts and audit accounts per request.
• Work closely with the dental practices in protecting the assets of Coast Dental by properly training the staff when errors are made and how to correct them. Work to eliminate errors through education and training.
• Manage 3 rd Party Orthodontic Lender accounts in “pending” or “hold” status by pulling weekly reports online and emailing the offices to resolve or calling the lender directly to inquire on accounts.
• Streamline ortho billing and audit Orthodontic starts for accuracy and proper filing with insurance, if applicable.
• Analyze balance transfer request and complete transfers as appropriate between dental practices.
• Verify daily adjustments performed, claim errors, NEA attachments not submitted, claims not sent, and rejected claims per location.
• Research and post insurance takebacks to all accounts involved and open tasks for the office to adjust balance as necessary, or research and submit a corrected claim. The accounts should be properly notated after adjustments are made.
• Perform other duties, as assigned.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Qualifications
Knowledge, Skills and Abilities
• 5 year of experience in an insurance claims processing role, medical/dental setting and/or accounts receivable and collections.
• Problem Solving- Identifies problems in a timely manner; Gathers and analyzes information skillfully.
• Oral Communication- Listens and gets clarification; Responds well to questions. Maintains constant and open communication with all parties involved in each issue.
• Written Communication- Writes clearly and informative; Edits work for spelling and grammar; Varies writing style to meet needs; Able to read and interpret written information.
• Teamwork- Balances team and individual responsibilities; Contributes to building a positive team spirit.
• Intermediate computer proficiency in Microsoft Office including: Word, Excel and Outlook.
• Professionalism- Accepts responsibility for our own actions; Follows through on commitment.
• Capable of working independently.
Qualifications (Experience, Education, Licensure, Certification)
• High school diploma or equivalent.
• Minimum of 1-2 years of medical or dental collections experience.