Medical, Clinical & VeterinaryClinical Support & Patient Administration
About the job
Requirements
A high school diploma or GED is required.
Four years of business office experience is required.
At least one year of dental experience is required.
Strong customer service skills are required.
Knowledge of basic accounting principles is required.
Knowledge of medical billing and collection practices is required.
Knowledge of insurance requirements for third-party payers, Medicare, and Medicaid is required.
Ability to analyze patient accounts and maintain detailed records, files, reports, and correspondence is required.
Basic computer and keyboard skills are required.
Ability to work independently or on a team, identify and resolve problems, exercise sound judgment, communicate effectively, prioritize workflow, and meet stringent deadlines is required.
Ability to comply with business conduct, ethics, integrity, confidentiality, asset-protection, and billing and collections fraud-prevention requirements is required.
The role requires prolonged sitting and computer work and the ability to lift up to 15 pounds.
The role requires working in a clinic office environment with possible exposure to communicable diseases and medical preparations.
Responsibilities
Prepare and submit clean claims to third-party payers electronically or on paper.
Coordinate patient eligibility verification through various third-party sources.
Maintain assigned work queues.
Ensure Medicare Federally Qualified Health Center billing is correct.
Manage denial and insurance follow-up activities.
Issue adjusted, corrected, or rebilled claims to third-party payers.
Collect and add information for workers’ compensation and motor vehicle claims.
Accept and run the weekly statement batch.
Assist with setting up patient payment plans.
Request insurance and patient refunds.
Maintain confidentiality and adhere to HIPAA guidelines and regulations.
Report concerns and issues to the Revenue Cycle Manager.
Answer phone calls from patients and insurance companies and return after-hours Business Office messages.
Explain benefits to patients and respond to inquiries about unpaid insurance claims.
Correspond with insurers and provide updates.
Identify and resolve patient billing problems.
Take patients’ credit card payments over the phone.
Perform other assigned tasks.
Desired Qualifications
Two years of post-high-school education or a degree is preferred.
Four years of third-party payer billing experience is preferred.
Description
Riverland Community Health is a Federally-Qualified Health Center in St. Paul, where patients receive community-based Family Practice medical care in addition to mental health, dentistry, social work and other integrated services. When joining RCH, you become part of a diverse, inclusive, and welcoming team who are dedicated to serving our patients and pursuing our mission to deliver excellent healthcare for all and training for the providers of tomorrow.
JOB SUMMARY:
The Dental Billing Specialist manages the claims process, including accurate and timely claim creation, follow-up and correspondence with providers, insurance inquiries/correspondence. This position is responsible for assisting in the clarification and development of process improvements and inquiries; and assuring payments related to patient services from all sources are recorded and reconciled timely in order to maximize revenues. Other important duties include credentialing, enrollment processing, and reporting. The Dental Billing Specialist performs clinical support services and assigned related work such as adding liaison from dental department to patients and patient services, under the direct supervision of the Revenue Cycle Manager.
ESSENTIAL FUNCTIONS:
Administrative Duties:
Prepare and submit clean claims to third party payers either electronically or by paper.
Coordinate the process of patient eligibility through various third-party sources.
Maintain assigned Work Queues (WQ)
Ensure Medicare Federal Qualified Health Center (FQHC) billing is correct.
Denial and insurance follow-up management.
Issue adjusted, corrected, and/or rebilled claims to third party payers.
Collect/Add information for Workers’ compensation and motor vehicle claims.
Accept/Run the weekly statement batch.
Assist in setting up payment plans with patients.
Request insurance and patient refund.
Maintain strictest confidentiality; adheres to all HIPAA guidelines/regulations
Report concerns/issues to Revenue Cycle Manager.
Customer Service:
Answer phone call from patients and insurance companies.
Return message left on the after-hours Business Office line.
Explain benefits to patients.
Respond to patient’s inquiry on why insurance did not pay.
Correspond with and provide updates to insurances.
Identify and resolve patient billing problems.
Take patients ‘credit card payments over the phone.
Perform other tasks as assigned.
Requirements
SUPERVISORY RESPONSIBILITIES:
None
KNOWLEDGE, SKILLS AND ABILITIES:
Strong customer service skills.
Excellent written and verbal communication abilities.
Ability to work independently or on a team.
Skill in identifying problems, problem solving and resolution.
Ability to analyze patient accounts.
Knowledge of basic accounting principles.
Knowledge of medical billing / collection practices required.
Knowledge of insurance requirements for third party payers, Medicare and Medicaid.
Demonstrate sound judgement and decision-making abilities.
Ability to prepare and maintain detailed records, files, reports and other correspondence.
Ability to establish and maintain effective communication.
Ability to perform the job in accordance with Riverland Community Health’s Standards of Business Conduct, which includes compliance, ethics and integrity, confidentiality, protection of assets and avoidance of conflicts of interest and inappropriate business relationships. Specifically, work processes that involve billing/collections practices for avoiding activities that constitute fraud and abuse.
Excellent time management skills with the ability to prioritize work flow and meet stringent deadlines.
Basic computer skills.
Strong keyboard skills.
EDUCATION/EXPERIENCE:
High School Graduate or GED is required.
Two years post high school education or degree preferred.
Four years business office experience is required.
Four years third-party payer billing experience is preferred.
Minimum of 1 year of dental experience required.
CERTIFICATES, LICENSES, REGISTRATIONS:
N/A
PHYSICAL DEMANDS:
Prolonged periods of sitting at a desk and working on a computer.
Must be able to lift up to 15 pounds at times.
WORK ENVIRONMENT:
Work is performed in a clinic office environment. Contact with staff, patients and outside agencies. Possible exposure to communicable disease and medical preparations common to clinic environment.
Salary is $21.50 to $31.50 hourly DOE.
A summary of our benefits include but are not limited to: health, dental, vision, HSA, FSA, basic life insurance, voluntary additional life insurance, spousal and child insurance, long-term disability, and a 403b retirement plan.
In addition, job offers made during flu season are conditioned on the candidate receiving the annual flu vaccination before their start date.
RCH is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.