The Medical Biller will be responsible for the processing of all Medical claims electronically. Such responsibilities include but are not limited to auditing, tracing and processing appeals for erroneous denials or inaccurate reimbursement of medical claims.
– Processes encounters that include CPT, HCPCS, and ICD-10 codes for daily medical billing.
– Confirms appropriate CPT, HCPCS, and ICD-10 to ensure compliance and reimbursement accuracy.
– Act as a liaison between the CBO (Central Business Office) department, dental billers, and third party payers in resolving billing and reimbursement accuracy.
– Processes medical claim appeals.
– Attains required information to ensure payment claims are sent out with supporting documentation.
– Audits electronic claim reports by validate CPT, HCPCS, and ICD-10 discrepancies and makes the appropriate corrections required for claims to be sent electronically.
– Requests any additional information from office that is needed to make the corrections.
– Generates weekly reports for unbilled encounters and ensures insurances are billed in a timely manner.
– Reviews and sends out re-submittals for appeals.
– Prepares and performs written reports of all accounts for tracing.
– Audits and traces medical claims to ensure timely and accurate reimbursement.
– Collaborates with the Auditor and Claim tracer for processing Dental claims.
– Files and follows up for Third Party medical claims.
– Processes requests via email from offices in the field including filling dental services to medical payers and benefits and eligibility – precertification of specialized services.
– Processes attachments through NEA.
– Provides customer service to the affiliated dental and medical practices of PDS, through the call center, as well as email.
– Equivalent to high school diploma or general education degree (GED).
– +6 years’ experience in dental or medical billing.
– Bachelor’s or Associate’s Degree from an accredited college.
– Knowledge of QSI, NextGen.
– Customer Service Certificate program.
Your commitment to Pacific Dental Services® is the key to our success. In turn, we’ll reward you with a benefits package that shows we care about you, your family and your future. We encourage team members to develop their distinctive talents and strengths—and embrace an entrepreneurial spirit that rewards individual achievement.
Location: Henderson, NV, US
Company Name: Pacific Dental Services
Pacific Dental Services (PDS) partners with individual owner dentists across the U.S., providing them with business support services so they can stay focused on their passion: dentistry. PDS and its supported owner dentists offer career opportunities nationwide.
Established in 1994, PDS has been ranked in Inc.’s 500|5000 list of America’s fastest-growing private companies for eight years in a row, and continues to grow. PDS is founded on a core set of values that guides our daily lives, distinguishes the strength and character of our organization and directs our critical decisions. At PDS and in our supported offices, we aim to be the very best at everything we do. Fortunately, that helps us attract the very best team members – and we hope you’ll be one of them.
Job Reference: Req5985