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Form of workJob Description
West Cecil Health Center is looking to add to their Medical Practice Team! WCHC is looking for dedicated, driven, Billing and Credentialing Specialist - Dental Focused who is passionate about their work, wishes to make a difference in their community and are interested in continued development.
If you’re looking to work for an organization that offers great benefits, growth opportunities and a positive atmosphere, this is the job for you!
POSITION SUMMARY Billing and Credentialing Specialist - Dental Focused
Function as a subject matter expert in medical/dental practice revenue cycle, to include review of coding and processing of claims, provider credentialing and insurance enrollments. Supports the company’s core values by exhibiting integrity, trust, respect, compassion, quality, teamwork, accountability, communication, and a commitment to the community.
WHY SHOULD YOU APPLY?
- Growth and Advancement Opportunities
- Company Sponsored Events
- Employee Engagement Committees
- WCHC offers a compressive benefit package including:
- Medical, Dental, and Vision insurance
- Health Reimbursement Arrangement
- Employer paid Life and AD&D and Disability insurance
- 401K with employer match
- Generous Paid Time Off and Volunteer time
- Paid Holidays
- Education reimbursement
- Pay $$21.00 - $26.00
PRIMARY ACCOUNTABILITIES
Achieve Results
- Ensure timely and accurate submission of all claims including following up with third party payers
- Daily review of rejected/denied claims; making edits or appeals to resolve errors to ensure expedited processing
- Management and reconciliation of daily Time of Service (TOS) batches/deposits
- Enter payments and denials to patient accounts. Contacts patients regarding outstanding balances and follows up on previous payment commitments
- Coordinates predetermination requests in a timely and accurate manner
- Monitor and manage the collection process, patient account aging, and adjustment/bad debt reporting while keeping management informed of billing, credentialing and collection issues
- Assist in the analysis and reporting of Accounts Receivable. Utilize systems to collect, analyze, and report information to management in a timely and accurate manner
- Audits credit balances and refunds payers and/or patients when overpayments occur
- Answers patient billing questions verbally and/or in writing
- Perform other related duties as needed
- Ability to comply with and adhere to all regulatory compliance areas, policies and procedures
- Ensure effective, positive relationships within and among other department staff, as well as other functional areas within the organization
- Develop and ensure favorable working relationships with vendors, third party payer resources, and related external resources
- Uphold and consistently represent the values and mission of the organization at all times
- Represent the organization in a highly professional manner at all times
ESSENTIAL FUNCTIONS/ KEY COMPETENCIES
- Demonstrate a high level of problem solving skills. Demonstrate the ability to make critical decisions supported by data.
- Proficiency in Word and Excel
- Excellent attention to detail and able to prioritize tasks.
- Demonstrate interpersonal savvy and influence skills with the organization’s leaders, staff, regulators, vendors, auditors and related external entities.
- Ability to routinely and creatively use and understand technology necessary to collect, retain, analyze and report financial information.
- Ability to regularly and effectively communicate throughout all levels within the organization in written, verbal, and presentation format.
SUPERVISORY RESPONSIBILITY
This position has no supervisory responsibilities.
POSITION TYPE AND EXPECTED HOURS OF WORK
- This is a full-time position.
- Days and hours of work will be scheduled Monday through Friday, between 8:00 a.m. and 5 p.m.
LOCATION/TRAVEL
- Located in West Cecil Health Center - Hybrid options available
- No travel is expected for this position
POSITION REQUIREMENTS
Education
- High School Diploma/GED required
Experience
- Demonstrated experience and significant knowledge of dental coding, Billing and Credentialing, 3-5 years Dental Billing experience, preferred.
- Significant computer and Electronic Health Record (EHR) systems knowledge required. Knowledge of eClinicalWorks is preferred.
- Federally Qualified Health Center billing experience is preferred.
- Significant knowledge of federal and state billing regulations and Credentialing requirements.
- Demonstrated analytical skills and aptitude for solving problems.
- Demonstrated high level of communication and customer service skills
Physical/Environmental
- Ability to interact with computer screen. (Visual acuity required).
- Must have manual dexterity for use of keyboard. Ability to remain stationary for periods of up to four hours. Ability to communicate via phone, mail and in person to resolve disputes, solve problems, etc.
- Cognitive skills to analyze, calculate, problem solve issues related to the billing, credentialing, and other relevant processes.
OTHER DUTIES
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
At WCHC, we embrace diversity and we don’t discriminate against employees or applicants based on gender identity or expression, sexual orientation, race, religion, age, national origin, citizenship, disability, pregnancy status, or veteran status.
