Proficient in relevant computer applications. Billing Specialist. Printing the patient statements appealing all unpaid claims with insurance companies. Objective : Results-driven Billing Specialist with a progressive career in billing and office management. Utilizing computer programs, spreadsheets and other systems, such as Microsoft Office systems. Apply to Dental Specialist, Dental Insurance Billing Professional - Extradent, Dental Assistant and more! Providing billing support for client companies through temporary work assignments. Capable of working and communicating well in a matrixed environment with Dental Directors, Sales, Dental Provider Relations; National Appeals Unit, Credentialing, Legal, Policy and Compliance, Healthcare, Service Operations, Marketing; as well as state regulators and auditors, Excellent oral and written communication skills are required, Must be detail oriented, highly organized, deadline driven, and self-motivated, Must possess project management expertise with demonstrated experience in managing multiple projects and priorities, Skilled in the use of Microsoft PowerPoint, Word, Excel, and Outlook, Excellent analytical, quantitative, and problem solving skills, Capable of quickly learning and mastering the intricacies of a variety of IT systems, Experience in the various aspects of a strong Quality Management Program, Strong background in the Credentialing and Recredentialing of dentists, Knowledge of NCQA and other medical/dental quality standards and state specific regulations regarding quality programs, Command of dental terminology, clinical procedures, and benefit language, Financial acumen for assisting in financial analysis. Ensures required authorization of, Education: Associate's Degree or some college, Field of Expertise: working knowledge of dental management systems, preferably axiUm. The Billing Specialist Resume gives a list of certain core tasks such as – receiving and sorting incoming payments, checking the debit account validity period, updating accounts receivables, issuing and posting bills, receipts and invoices; ensuring all clients are properly informed about outstanding debts and their deadlines, and creating a detailed report on all billing activities. Ensure all visit slips are accounted for, Balance cash drawer, complete bank deposit&perform other cash duties, In the event of an emergency, respond in accordance w/ established emergency guidelines, Answer Health Record Pull General Update (HPGU)&send charts to other clinics as necessary, Perform other duties as assigned by the Dental Office Mgr, Two (2) years of health care/dental care OR two (2) years of cash handling and/or customer service experience in a high volume customer service environment, Two (2) years of dental office experience, Perform check in, check out and customer service support to members, patients, staff and dentists. associate, manager, officer), Knowledge and experience with MetLife internal systems, Experience in creating and maintaining cross-functional partner relationships, Ability to work independently and/or in a team environment, A history of ability to present findings and knowledge to senior management, Creative thinker with strong organizational skills, Strong analytical skills and base of knowledge in the insurance industry, Excel, Word, and PowerPoint knowledge a must, Able to operate efficiently in a fast-paced sales environment, 3D printer or 3D CAD industry experience beyond dental and medical, Please note this position is based out of our Somerville, MA office, Gather and report utilization data to management, Perform initial review of authorization requests to confirm completeness, Perform outreach to provider offices for additional required documentation, Manage and resolve high profile, escalated provider and member complaints, and grievances and appeals, Develop provider correspondence and various reports to present to management, Assist with HEDIS production functions including data entry, calls to provider offices and claims research, Train and serve as the point of contact for Program Coordinator team members on dental utilization activities, Does not conduct any UM review activities that require interpretation of clinical information, Does not choose a set of criteria to use for handling a request for healthcare services or treatments, Review complex claims and estimates for completeness and follow processes for incomplete information on claims, Assess and adjudicate complex claims and estimates, Assessing includes studying dental information and plan provisions, researching, documenting results and communicating verbally and or in writing with the client (member/sponsor) to obtain additional details in order to make an informed decision, Meet production and quality standards set for individuals, teams and department (timeliness, quality and service), Handle external and internal inquiries via written correspondence, e-mails and telephone as required, Participate in departmental projects as required, Work in conjunction with the Dental Consultant on contentious cases, and with other departments/offices within the company in order to meet customer expectations, 1) Learning about basic insurance product development lifecycles, 2) Exposure to project management, UX (user experience), waterfall and agile methodologies, 3) Exposure into how business development interfaces with technology teams to take concepts to implementation and delivery (including how we define our minimum value product and project plans), 4) Learn about healthcare related government programs and regulations, 5) Work on data and analytics and building databases for metric and reporting, 6) Product positioning and marketing interfacing with distribution, 7) Integration of product plan administration platforms (this is both operation lean six sign work exposure and technical IT Visual Basic mapping work), Performs all routine intraoral radiographic procedures, Performs all darkroom technical procedures, Sorts and accurately mounts intraoral films, Ensures patient x-rays are forwarded to chart area, Demonstrates to students and faculty the proper use of x-ray equipment and, Directs patients about appropriate dental care treatment using defined policies and procedures. Contacted the patient's doctor for a referral for non-emergency services. Media and Entertainment Resume Examples. Familiarity with CDT and ICD codes will be advantageous. S/he acts as an improvement catalyst for all quality-related and will help in communications to providers on new focus and measure/process changes. Responds to member/patient request for information, whether made in person or via telephone, in a timely and courteous manner, making eye contact if in person, using a pleasant expression and tone of voice and attempting to resolve requests at the point of initial contact or with as few referrals as possible. RDH, Communicate with UnitedHealthcare dental directors regarding appeals recommendation rationales and benefit interpretations with escalated cases/issues when own team is involved, Manages and runs appropriate own team meetings to ensure compliance with requirements, i.e. Significantly reduced denials for skilled nursing facility charges by over 65%. Verifying that billed medical services, diagnostic tests and medications were supported by the patients' diagnoses before sending claims to carriers. Communicating with utilities and clients to maintain accuracy in the billing process. Product Specialist will assist in the exchange of product if needed and communicate with account throughout the entire process until completed, Work closely with new product development teams to plan and execute design validation strategy, Work closely with marketing and executive management to identify clinical study opportunities and priorities, Develop/approve/edit protocols, case report forms, and statistical plans, Ensure appropriate regulatory controls (site and patient) in place for studies and design validations, Monitor data collection to ensure timely completion of all studies and design validations, Lead clinical risk assessment for adverse events, participate in decision on field corrective actions. Monitoring gateway clearinghouse to ensure timely filing for electronic claims, and to make any corrections on the claims if needed. Most dental schools curricula would require a training of four years; some states however require dentists to also complete a post-graduate residency program. Following-up with insurance companies to ascertain the appeal letters have been received, as well as, checking the status of the appeal letters. Hoping to resume as a Medical Billing Specialist at Savior Medicals; coming with 5+ years of billing experience in a medical setting to provide effective and efficient data entry and invoicing services, as well as to expedite insurance claim payments. Fully capable of operating independently or as a member of a dental team. Works with finance to manage the annual and quarterly forecasts, Manages a range of projects that support our strategic and tactical efforts, including market research studies, development of customer-facing marketing collateral (brochures, emails, web pages, trade advertising, etc. Analyzing monthly account receivable reports to ensure timely filing, third-party payments, and consistent cash flow. Followed-up on all unpaid insurance claims answered patients questions regarding their bills, processed all refunds, performed insurance and patient collections. Conforms to established policy and procedure governing confidentiality of all patient and Kaiser Permanente and Permanente Dental Associates information and records and the release of such information both inside and outside the program - always acts in a manner that will protect and preserve this information. Computer: Meditech, MDEverywhere, Advantx, Synapse, Nextech, IDX, EPIC, MS Outlook, MS Word, MS Excel. Order/replace secondary hazard communication container labels as needed. Responsible for documenting billing activity including but not limited to the following: bill dates, notes, and electronic note posting. Works under general supervision. Also requires contact with Provider Services, Membership Accounting Reps and/or Payment Services, New Business & Benefit Services, Customer Response Unit (CRU), Special Investigation Unit, Dentist Consultants, Dental Standards and Claim Distribution Coordinators before claim may be completely processed, Requires technical expertise, excellent written communication skills and sound judgment, Ability to problem solve and make prompt decisions, Key stroke skills required (alpha numeric – 5000 key strokes per hour recommended minimum), Insurance experience useful, as is an understanding of (or familiarity with) dental terminology and procedure codes, Input, analyze and assess claim submissions, Evaluate and process claims in accordance with contractual limitations and standard operating procedures within agreed service level through the aid of published claims manual, Consistently meet or exceed accuracy and productivity standards, Refer a claim for inquiry and clarification when necessary, Nice to have: Knowledge of/or work experience in the insurance industry, claims processing in particular, Basic computer and keyboarding skills with a minimum of 30 WPM, Must pass business unit CGB Math exam with a score of at least 7, Efficient time manager with ability to prioritize tasks, Detail-oriented with quick assessment skills, Superior problem-solving and decision-making skills, Positive attitude with willingness to learn, Flexible and adaptable, contributing to a positive team environment, Commitment to handling private and confidential information with a high degree of professionalism, Good understanding of Claims Processing / Adjudication, Proficiency in GB Citrix applications and navigation of GB Claims Manual, Apply knowledge of dental practice procedures, group benefits, claims payment and administrative practices to review, manage and assess incoming claims and referrals, assess risk, provide direction, assign priority and take appropriate action, Create, track and update referrals, investigation activity and fraud and abuse management tools, Communicate over the phone, in person or in writing with plan members, providers of service and other stakeholders, Create written audits and other correspondence to plan members, providers of service and other stakeholders, Generate, manipulate and analyze data to identify anomalies, trends, patterns and outliers. Ability to train personnel Knowledge Skills. To work for and with a company that promotes advancement and learning. Please contact us today to discuss this opportunity! Download Dental Resume Sample as Image file, Registered Dental Assistant Resume Sample, Grievance and Appeals - the Plan Dental Director maintains an active liaison with UCS G&A, reviews dental and medical/dental cases, and is responsible for representing the Local C&S plan at State-level Fair Hearings as requested, Oversee dental policy development and administration. Use professional field-tested resume templates that follow the exact ‘resume rules’ employers look for. Creates and sustains a culture based on trust, mutual respect, and common understanding of needs, Participates and collaborates with local community programs as appropriate to JPS strategic goals, Prepares annual budget ensuring financial stewardship for the facility in both operational and capital acquisition processes. Preparing journal entries to post to the general ledger on a monthly basis. Working closely with the billing supervisor to ensure claims are correct to secure prompt payment. Resume Text. Skills : Microsoft Office, Excell, Power Point. Verifying insurance for patients and verified referrals and pre-certification as needed. Determines if patients' insurance is contracted with USC and determines and collects co-pays.Works with patients who require financing to obtain or design financing, payroll deduction, payment plans, etc. Document arrivals, cancellations, reschedules, etc, Instruct new patients to fill out Health Questionnaire&Personal Data Form, Verify personal data on Visit Slip. Ensuring all payors are processing according to contracts, negotiating all non-par agreements and working with the collection agency on past due accounts. (Required), Transcripts if using education to qualify, Copy of most recent Notification of Personnel Action (SF-50) if current or former federal employee. Coordinates and collects child dental outcomes with Dental program partners such as Advantage, Head Start, etc. Worked with both medical and dental claims and following the FQHC guidelines. May be responsible for reserving conference rooms and coordinating audio/visual equipment and catering, Responsible for distributing incoming and outgoing mail, such as mass mailings, appropriately, Types letters and correspondence upon request, including e-mails. Product issues must be reported to a Technical Service Representative and Marketing for rapid response initiation. Detailed organizational ability with groups, projects, and assignments. Handling incoming calls from patients who have billing inquiries. Computer Literate Keyboarding 65 wpm. Billing Specialists ensure the efficiency of billing operations and besides handling invoices, payments and financial records also perform a variety of administrative and clerical tasks. Maintain a clean and orderly laboratory, Clean sterilization and other clinical equipment, including operatories, operatory equipment and hand pierces, in accordance with Infection Control Guidelines and the manufactures’ recommendations, Run x-ray test film, replenish processors, clean processor rollers and change solutions in accordance with department standards, Monitor shipment and receipt of hand piece for routine maintenance, Order/replace secondary hazard communication container labels as needed, Maintain Hazardous Communication Policy Manuals, Perform other duties as assigned by the office supervisor that are consistent with the individual’s training and experience in an active and cooperative manner, Participate in the confirmation calling process, Enter/Receive selected information into/from the Program’s automated dental information system, In support of existing staff, participate in the coordination and processing of provider schedule print-outs and dental records, Participate in maintaining an adequate inventory of dental instruments and supplies within the assigned dental office, Prioritize the pending problem tickets, work orders and pipeline development projects based on business need and return on investment, Provides indirect leadership to Dental Operations and IT Partners, Act as a key escalation contact for system outages, issues and break - fix situations, Adapts departmental plans and prioritizes work load to meet business objectives, Influences strategic decisions, departmental plans and prioritizes work in alignment with operational challenges, Lead cross - functional program to proactively address issues and system processes to meet business objectives, Create and deliver presentations to leadership on key initiatives, Partner with IT and Operations to develop and monitor controls to detect and prevent defects within projects by ensuring strong test plans and program teams, Communicate findings and recommendations to Senior Leadership, Bachelor’s Degree or equivalent experience, 5+ years of experience managing programs and / or projects, 5+ years of experience in health care industry, 5+ years of experience in a cross - functional / highly matrixed organization, Intermediate proficiency with Outlook, Word, Excel and PowerPoint, Experience with Facets (a Trizetto application), Excellent time management, organizational, prioritization skills and balance with multiple priorities, Self - motivated with ability to work both independently and in a team environment, Collect and review visit slips for proper completion and patients’ treatment status. Maintaining a professional appearance and providing a positive company image to the public, Education to degree level with BS or BA preferred (depending on geography) and/or equivalent experience, Previous sales experience and/or sales internship experience, Three or more years dental industry sales experience is preferred, Responsible for achieving annual sales goals and expanding market presence within the assigned territory, Experience with maintaining and growing a multi-million dollar territory with 250 or more accounts, Proven talent in developing customer loyalty, Experience with selling through distribution channels, Health care industry related experience including dental manufacturers and distributors; dental labs; hygienists; dental assistants; pharmaceutical; medical device, Knowledge and understanding of the competitive landscape in health care products, prices and policies, Knowledge and understanding of professional selling process and skills, Experienced with Microsoft Office application software, on-line sales support systems and Internet savvy research capabilities, Ability to consistently meet and exceed sales target, Lead efforts to analyze and utilize customer insights collected from Bellwether, Benchmark, faculty surveys, and NXT Customer Satisfaction and case type data to improve the customer experience and our products (ideation, development, and iteration), Respond to customer inquiries and issues as necessary, Support Pre-Health Content Managers in addressing errata across publishing and retail products, Diploma degree in science, pharmacy, biology, Sterilize and process dental instruments in accordance with Infection Control Guidelines. Headline : Billing Specialist with 15 plus years of experience is looking to secure a position within an established organization with a stable environment that will lead to a lasting relationship in the field of Health Care. 379 Dental Billing Specialist jobs available on Indeed.com. Passionate about data management within the health claims industry. Identifying additional billing edits required to submit clean and compliant billing to various payers. The Dental director may also act in a similar capacity for Non C&S HEDIS, STARs as directed by UCS regional CMO (provider and member survey components). In support of existing staff, participate in the coordination and processing of provider schedule print-outs and dental records. instrument case carts when necessary, The hygienist is to put up flag outside the operatory to signal the processing technician that x-rays need to be developed and mounted. Primary local responsibility is to support dental linkages to PCCM/Accountable Care Community (ACC) growth through identification of appropriate practices; initial contact and into implementation where applicable. Highly effective communicator and team leader with proven ability to build long-term relationships with internal and external customers establishing a high level of confidence and trust. Additionally the Plan Dental Director, working with dental staff, has primary responsibility to oversee new clinical model operations where appropriate, including Person-Centered Care Models (PCCM), (Accountable Care Community/ACC) relationships, and new Models of Care programs such as those defined by AHCCCS, DDD and/or the Center for Medicare and Medicaid Services (CMS). Skills : Customer Service, Medical Coding, Medical Billing, Medical Terminology, Medical Records, Accounts Receivable, Reconciliation, How to write Experience Section in Banking Resume, How to present Skills Section in Banking Resume, How to write Education Section in Banking Resume. Search Dental biller jobs. Establish consistent best-in-class practices for health-hazard evaluations, Work with investigators to proactively identify presentation and publication targets, Develop and manage comprehensive clinical education program for all content and geographies, Propose and manage educational content, speakers, administrative, and promotion of company sponsored programs, Provide mentoring and guidance to subordinates and other employees, Monitor and manages all aspects of the clinical affairs budget, Develop necessary departmental processes for all dental platform, Strong working knowledge of dental workflows, Ability to identify, research and analyze general business periodicals, professional journals, technical procedures, or governmental regulations, Ability to apply mathematical operations to such tasks as frequency distribution, determination of test reliability and validity, analysis of variance, correlation techniques, sampling theory, and factor analysis, Provide strong organizational leadership, ability to organize complex work, drive change and instill a culture of execution, in RAQA as well as across the broader organization, Creates an environment that attracts, develops, and retains high quality employees, foster employee engagement, diversity, professional development and high levels of employee satisfaction, Ability to write reports, business correspondence, and procedure manuals, Provide&request information of other departments&external firms, Assist other staff members&providers as needed to ensure orderly&efficient patient care, Explain to patients how they can get various information, e.g., our Information Center, their benefits office, etc, Receive patients during check-in&check-out process, Answer staff questions regarding daily schedule. , etc. acceptance rate of commercial claims through well-researched appeals proving medical.. 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