Insurance Verification Specialist

Job Title: Insurance Verification Specialist

Essential Job Functions:

● Verify Insurance - a minimum of 3 days out for all assigned offices

● Complete same-day verifications within 1 hour of receiving request

● Respond to office requests and inquiries in a timely manner

● Posting Insurance Checks - ensure that dollar amount posted balances with Opendental; if not, figure out where the discrepancy is and solve it

● Write-offs - ensuring that claim write-offs are accurate and match EOB; when patients have more than one insurance, ensuring that patient is not given credit when not due

● Be able to identify teeth numbers both in patient chart and patient x-rays

● Sending Claims to Insurance - ensure that the correct billing and treating provider are listed prior to sending of the claim; all necessary attachments are properly submitted with the initial claim submission

● Sending secondary claims with primary eobs/other necessary information attached

● Creating detailed narratives for claim submission using information from patient's chart notes/x-rays/account notes

● Confirming that submitted claims were not rejected in the claims software; correcting and updating any information that caused claim to be rejected

● Patient Account Audits - checking for and correcting inaccuracies (whether from office orbilling team)

● Regularly refer to Billing Guide for changes in fee schedules

● Regularly review Billing Guide for changes in AR and respond to those changes

accordingly

● Regularly update and review Work Tracking Google sheets, Adjustment Tracker, Denial/Appeal Tracker

● Claim Follow-Up -Calling insurance/utilizing online resources to check the status of outstanding and pending claims; notating account in patient commlog

● Claim Appeals - Send out first-level appeals in timely manner (when initially denied) with all necessary information attached, notating account when and how the appeal was sent (by mail, electronically, fax, etc.)

● Printing Statements - Once all claims on family account have been closed

● Notating/Dating where patient account balances are coming from

● X-ray Adjustments - adjusting off x-ray balances when necessary

● Account Adjustments - accurately adjusting account balance when notated by office

● Ensuring adjustments and patient payments are attached to procedures correctly

● Credits - reviewing account credits to determine their validity; utilizing patient account credits when appropriate

● Attending bi-weekly billing meetings and participating in group discussions

● Communicating with team members on Slack

● Creating insurance website logins for offices when needed/requested

Reguirements:

● Self-motivated

● Prioritize time management

● Math Skills

● Detail oriented

● Embrace change

● Proficient computer/basic Excel skills

● Communicate appropriately with peers and office(s)

● Team player

Qualifications:

A Billing representative will be responsible for facilitating the insurance needs of the office remotely. Effectively manage time in order to complete daily verifications and respond tooffice inquiries and requests. Be able to adapt to and embrace change when necessary, as wellas aiding team members when needed. Review accounts for accuracy, post insurance checks, and send claims on a daily basis. Follow up with outstanding/pending claims on at least a monthly basis and note the interaction on the patient's account ledger.

Must have Dental Front Desk backgroud experience.

If you possess the required skills and qualifications for this position, we invite you to apply. We offer competitive compensation, comprehensive benefits package, and a positive work environment. Please submit your resume for consideration.

Must live in the Central Florida or surrounding area.

Job Type: Full-time

Pay: From $21.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Weekly day range:

• Monday to Friday

Work Location: Remote