Dental Care Coordinator and Billing Specialist - Guadalupe, AZ

Dental Care Coordinator And Billing SpecialistWe are looking for a meticulous and organized Dental Care Coordinator and Billing Specialist who effectively captures the dual responsibilities for managing patient care and handling billing processes. The ideal candidate will be a healthcare professional who manages the billing and collections processes, ensuring accuracy and efficiency in handling patient accounts and insurance claims. They will also be responsible for managing and coordinating questions about larger treatment plans or referrals to specialists that the patient may have.The ideal candidate will:Billing and Claims Management: Prepare, submit, and track dental insurance claims.Monitor and ensure timely payments from insurance companies.Review and appeal unpaid or denied claims.Generate and issue invoices to patientsPatient Account Management: Maintain accurate patient billing records.Respond to patient inquiries regarding billing and payment procedures.Identify and resolve patient billing complaints.Process refunds to patients and insurance companies.Insurance Coordination: Verify patient insurance coverage and benefitsLiase with insurance providers to clarify patient coverage and resolve disputes.Stay updated with current dental terminology, coding, and insurance regulations.Credentialing new providers with insurance companies.Administrative Duties: Perform data entry and reporting tasks.Collaborate with dental office staff to maintain accurate patient records.Auditing to ensure patient information remains confidential and up to date.Coordinating Patient Care: Develop and manage individualized care plansSchedule appointmentsEnsure timely follow upsPoint of contact for provider/patient updatesPatient Education: Educate patients and approved family members about dental conditions, treatment plans, and available resources.Qualifications include:High school diploma or equivalent; additional education, certification in medical or dental insurance courses, dental assisting license, and radiology certificationPrior experience as a medical or dental billerFamiliarity with RPMS, CDT, and ICT codingExcellent organizational skills and attention to detailInterpersonal skills including excellent dental communications and strong writing skills for insurance claim correction/appeals and patient treatment plan presentationsAbility to work with sensitive patient information while maintaining confidentialityAdditional duties may include occasional coverage for the Patient Support Service Technician, including patient interactions, appointment management, managing patient records, and administration tasks.Required knowledge, skills, and abilities include:Knowledge of clerical and office support practices.Assigned department operations and functions.Customer services principles and practicesEnglish language, grammar, and punctuationTracking and reporting software, electronic systems for processing third party insurance billing, AHCCCS eligibility and enrollment requirements, RPMS, and Practice Management.Dental Terminology and Procedures: Familiarity with common dental procedures and terminology.More extensive mathematical concepts and ability to read budget sheetsFiling procedures and practicesInsurance Policies and Protocols: Understanding different dental insurances and credentialing processProficiency with billing softwareCDT and ICD codes HCFA 1500s and UB-92How to audit for appropriate procedure and codeDental Insurance process and procedureRadiology identification for insurance claimsHIPAA regulationsYaqui culture, customs, resources, and traditions and/or a willingness to learn.Maintaining files and recordsMust be able to prepare a variety of correspondence, records, reports, documents, and formsFollow oral and written instructions, policies, and procedures, operate a variety of office equipment, including a computer, fax, adding machine, and related software applicationAbility to manage multiple patients accounts, track payments, and handle billing cycles efficientlyAttention to detail: ensuring accuracy in billing, coding, and claim submission to avoid errors and denials as well as audits of providers procedures.Good communication and interpersonal skills as applied to interaction with co-workers, supervisor, management, Council members, and the public.

Have ability to sufficiently exchange or convey information and receive verbal and written work instructions.Customer Service: providing support and resolving billing issues for membersProblem-Solving: Ability to identify and resolve billing issues, including denied claimsTime Management: Efficiently managing time to handle billing tasks, follow-ups, and administrative dutiesAnalytical Skills: analyzing billing data and financial reports to ensure accuracy and compliantAdaptability: staying updated with changes in billing regulations and software updates.Interpersonal skills including excellent dental communications and strong writing skills for insurance claim correction/appeals and patient treatment plan presentationsAbility to work with sensitive patient information while maintaining confidentialityEducation, certifications, and experience required:High school diploma or equivalent; additional education, certification in medical or dental insurance coursesDental Assisting CertificateRadiology certification5 years of experience performing dental billing and insurance claimsTraining with RPMS, CDT, and ICT codingSpecial requirements:Must possess and maintain a valid Arizona Driver's License.Must have a current Level 1 Arizona Clearance Card or be able to obtain one within ninety (90) days of hire. Failure to maintain a current Level 1 Clearance Card will result in termination