Description

Under the general direction and supervision of the Director, Revenue Cycle, this position performs specific dental billing processes, to include, but not limited to, billing and third party payer filings, review of patient fee slips, review and reconciliation of invoices for patient related ancillary services, patient statement and account reviews, handling of patient inquiries regarding insurance and accounts, and patient collections. This position will assist to develop, plan, organize and implement current and future strategies to bill customers, process payments, minimize bad debt, improve cash flow and manage the overall health of the Dental receivables. Work is performed under minimal supervision and in accordance with established procedures. The Dental Biller position requires the use of computers and other office equipment

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:

• Oversees and/or performs coding to ensure accuracy and compliance with law.
• Oversees and/or performs patient billing to ensure timeliness, accuracy and compliance with law.
• Oversees and/or runs, verifies and submits patient billing, third party billing, collections and related reports.
• Follows-up with dental providers, as necessary, regarding coding.
• Strong customer service skills
  • Answering client calls
  • Prompt return and follow up to all interactions
  • Prompt response to requests for information, both internally and externally
• Responds to inquiries concerning patient accounts.
• Oversees, investigates, resubmits, re-files and/or files third party claims appeals if appropriate.
• Submits dental secondary third-party billings.
• Communicates billing and collections activity with Director, Revenue Cycle and Clinic Administrator.
• Conducts follow-up for delinquent insurance accounts.
• Monitors patient account receivables and identifies and refers delinquent accounts to the appropriate collections phase via Health West policy.
• Backs-up various billing processes with other programs as needed.
• Assists with processing patient refunds.
• Implements records retention schedule and policy.

SECONDARY:

• To attend company meetings as assigned.
• Exhibit a positive professional attitude at all times with supervisor, co-workers, health center personnel, patients, and the community at large while adhering strictly to the confidentiality of Health West financial, personnel and patient information.
• Participate in the company’s annual planning process when requested.
• Participate in professional development opportunities.
• Performs other duties as assigned by Director, Revenue Cycle.
• Remains current with standards of health care billing practices.
• Participates in continuous quality improvement activities.
• Complies with Center’s policies and procedures.
• Utilizes personal computer and specialized office equipment.

PHYSICAL REQUIREMENTS:

1. Hearing: Adequate to perform job duties in person and over the telephone.
2. Speaking: Must be able to communicate clearly in person and over the telephone.
3. Vision: Visual acuity adequate to perform job duties, including reading information from printed sources and computer screens.
4. Sitting for long periods of time and repetitive hand motions for data entry.

LEADERSHIP: Demonstrates willingness to try new tasks; communicate and discuss potential areas of risk to the appropriate manager; generates new ideas for change; evaluates and recognizes priorities; selects effective team members; challenges others to learn; keeps current and integrates new information; communicates and model’s organization values; fosters high performance; continuous improvement, recognizes need for and provides adequate resources . This position is responsible for role modeling and promoting Health West Inc. values throughout the organization.

INTERPERSONAL SKILLS: Demonstrates active listening techniques; gains support through effective relationships; treats others with dignity and respect; seeks feedback; creates and maintains reporting mechanisms.

LANGUAGE SKILLS: Ability to read, analyze and interpret professional journals, technical procedures or governmental regulations. Ability to communicate orally and through written reports and other documents relating to resident, staff and others. Ability to effectively present information and respond to questions from groups of executives, managers, clients, customers and the public

MATHEMATICAL SKILLS: Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions and decimals. Ability to compute rate, ratio and percent and to draw and interpret bar graphs. Advanced knowledge of computers is desired.

REASONING ABILITY: Ability to define and solve problems, collect data, establish facts and draw valid conclusions. Ability to interpret an extensive variety of technical journals and deal with several abstract and concrete variables.

QUALITY IMPROVEMENT: Applies quality improvement methods techniques; assists in data collection; Identifies processes for improvements in daily work and educates new employees in team process.

ENVIRONMENT OF CARE: Demonstrates understanding of emergency procedures; participates in emergency drills; demonstrates understanding of safety and security procedures; applies safety and security precautions; demonstrates understanding of hazardous materials plan; demonstrates Health West use of equipment and assists with disaster preparation exercises and learning.

INFECTION CONTROL: Applies hand washing principles during daily work; demonstrates understanding of isolation precautions; recognizes signs and symptoms of infection and complies with the employee health program; demonstrates understanding of the process for identifying and handling infectious waste; maintains personal hygiene; complies with OSHA standards in the work place; and demonstrates understanding of cross-contamination.

INFORMATION MANAGEMENT: Enters or records data timely and accurately; promotes confidentiality of information; logs onto the system using own password; logs off the system when leaving the work station; reports suspected violation of security/confidentiality issues; reviews data and identifies trends.

CONTINUING EDUCATION: Attends in-service and education programs as determined by Health West Administration; attends continuing education required for maintenance of professional certification or licensure.

PHYSICAL DEMANDS: The physical demands described here are representative of, but not limited to, those that must be met by an employee to successfully perform the essential functions of this job.

Position requires occasional lifting and carrying items weighing up to 20 pounds unassisted; requires frequent sitting and repetitive hand movements, occasional standing, walking, squatting, bending, and reaching, with some lifting, pushing and pulling exerted regularly throughout a regular work shift.

WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. The noise level in the work environment is usually moderate.

Qualifications

Education

• High School Diploma or Equivalent.
• Certification through American Health Information Management Association or its equivalent is preferred.

Experience

• Two years’ experience in billing required
• Prior collections experience preferred
• Prior billing and collections experience in a dental office preferred.
• Three years’ experience in accounting may substitute for billing & collections experience.

Knowledge, Skills and Abilities

• Knowledge of CDT codes and use of automated information management system software.
• Technically proficient computer skills.
• Thorough knowledge of common office equipment (copier, fax, printer, etc.).
• Excellent oral and written communication skills.
• Ability to organize and prioritize tasks.
• Ability to work under pressure and meet deadlines.
• Strong analytical, attention to detail and problem-solving skills.
• Ability to work independently and as a team member.