Overview Responsible for providing support to the Doctors, Practices, and Revenue Cycle Team with follow up on open and denied insurance claims.
Responsibilities Essential Job Duties: 1. Proactively follow up on outstanding insurance claims to ensure prompt processing:
- Work aging report to ensure unpaid claims have been received and are in process with payers
- Improve claim flow by working with Claims Team to proactively identify and resolve claim processing issues
- Finalize resolved claims in practice management system to release first party billing
2. Read and interpret payer explanation of benefits and verify claim adjudication in accordance with
contract guidelines.
3. Appeal and follow up on denied insurance claims:
- Review, identify and resolve claim denials
- Prepare and submit appeals for denied claims, monitor and track results
- Provide requested additional information to facilitate claim processing
- Monitor denials by reason, provider and payer
4. Resolve electronic claim rejections:
- Correct and resubmit claims stopped by internal clearinghouse
- Correct and resubmit claims rejected by payer's clearinghouse
5. Create, update and maintain insurance plans for billing in practice management system:
- Test payer IDs before releasing plans to the practices
6. Submit pre and retro authorization requests for planned and rendered services.
7. Personal and Professional Responsibilities:
- Effectively communicate and develop a strong working relationship with the Doctors and all
Team Members and promote teamwork through cooperative and professional behaviors - Create an environment which promotes trust, open communication, creative thinking, and team
collaboration - Assume responsibility for personal professional growth through internal and external training
opportunities and continuing education offerings - Follow and demonstrate commitment to the Park Dental policies, professional expectations, and Service Excellence Standards
- Serve as an example and representative of the organization by demonstrating behaviors consistent with Park Dental and The Dental Specialists Mission, Vision, and Values
- Strong computer, typing, and 10-key skills
Position Details: Tools and Technology: - Practice Management, NEA, EDI experience and knowledge
- Proven systems aptitude and strong MS Office skills (Excel, Outlook and Word)
- Familiarity with insurance company websites
- A quick study of new systems and software tools and a willingness to embrace technology to
improve productivity
Required Skills/Qualifications: - Possess strong communication skills and the ability to develop constructive and cooperative
working relationships with others, striving for collaboration and demonstrating professionalism - High skill level of interpreting a variety of payers' explanation of benefits
- Understands coordination of benefits guidelines in depth
- Ability to manage multiple activities simultaneously with minimal direction, while relying on
experience and judgment to plan and accomplish goals - Detail oriented and well-organized
- Self-motivated and the ability to work independently
- Able to effectively deal with multiple locations, variety of internal customers, and patient
situations
Education and Knowledge: - Minimum two year associates degree, bachelors degree preferred
- Healthcare denials management/billing experience
- Familiarity with Dental and Medical insurance claims
- Experience with verbal and written communication to healthcare professionals and patients
Work Schedule 8 hours daily Monday-Friday
Company Information Benefits Park Dental offers competitive compensation, and generous benefits package including medical, vision, dental, PTO, holiday pay, 401k matching, and continuing education opportunities.
Community Park Dental values being involved in the community through volunteer events, such as Minnesota Dental Association's Give Kids a Smile Day, the American Heart Association Heart Walk, and Minnesota Mission of Mercy. Each practice participates in events in their local communities too!
About Park Dental Since 1972, Park Dental has been owned and led by our doctors who are passionate about providing the best patient-centered care. New team members receive comprehensive training and one-on-one mentoring to set you up for success. Our practices offer welcoming environments for patients, and are equipped with state of the art technology.
"As a dental hygienist with Park Dental, we have the opportunity to engage patients in the process of improving and maintaining their oral health, which in turn leads to over-all health." -Berit Campbell, DH Mentor
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Park Dental is an equal opportunity employer.