Dental Claims Specialist

Description

Medicaid Specialist
Cambridge Dental Group – Dearborn Heights, MI

Cambridge Dental Group is seeking a detail-oriented and experienced CBO Team Member to join our centralized business office team. This role is essential in ensuring accurate and timely submission and follow-up of Medicaid pre-authorizations and claims. The ideal candidate will bring a strong background in Medicaid billing and revenue cycle management (RCM), with a commitment to accuracy and efficiency.

Responsibilities:

• Submit all Medicaid pre-authorizations and claims in a timely manner.
   
• Follow up consistently on pre-authorizations and claims to ensure proper resolution.
   
• Review and manage daily work logs to resolve outstanding claims.
   
• Appropriately document all account activities within the practice management system.
   
• Process EOB and R/A payments/denials accurately and promptly.
   
• Communicate effectively with leadership, co-workers, and dental offices regarding claim status.
   
• Maintain a high level of accuracy and attention to detail in all job functions.
   
• Provide backup support to other CBO team members as needed.
   

Required Qualifications:

• 5+ years of Medicaid billing and RCM experience (preferred)
   
• Proven ability to manage pre-authorizations and claims efficiently
   
• High attention to detail and task-focused work style
   
• Strong organizational and follow-up skills
   

Preferred Qualifications:

• Some dental clinical experience (helpful but not required)
   

Why Join Us:

• Full-time position with comprehensive benefits including health insurance, life insurance, PTO, paid holidays, disability options, 401k with match
   
• Be part of a supportive and collaborative CBO team
   
• Play a key role in ensuring smooth financial operations for our office
   
• Competitive compensation and growth opportunities within a trusted dental group
   

#indeedwavedp

Requirements

Education and Training

• High school diploma or equivalent required.
• Three years healthcare cash posting, billing, third party follow-up and collections experience required; OR a combination of education and/or experience in business or related field totaling three years.  
• Knowledge of automated business applications, including word-processing, spreadsheet and data base management applications required.
• Data entry experience and knowledge of Medicare, Medicaid, and third-party insurance preferred.

FLSA Status: Hourly, Non-Exempt

Reports to: VP of Finance