Join Our Team!

We are seeking an experienced, detail-oriented, and highly motivated Oral Surgery Billing Specialist to join our growing Oral & Maxillofacial Surgery practice.

The ideal candidate has a strong background in both medical and dental insurance billing, understands the complexities of oral surgery coding, and is committed to maximizing accurate reimbursement while maintaining compliance with insurance regulations.

We are looking for a professional who takes ownership of the revenue cycle, proactively resolves outstanding claims, and works collaboratively with our clinical and administrative teams to ensure financial efficiency.

Previous oral surgery billing experience is strongly preferred.

Key Responsibilities

Medical & Dental Insurance Billing

Prepare, review, and submit accurate medical and dental insurance claims for oral and maxillofacial surgery procedures.
Apply appropriate CDT, CPT, and ICD-10-CM codes based on clinical documentation and payer requirements.
Submit claims for dental implants, extractions, bone grafting, biopsies, pathology, trauma, and other oral surgery procedures.
Determine appropriate medical versus dental insurance billing pathways based on benefits, coverage policies, and documented services.
Verify insurance eligibility, benefits, and coverage limitations.
Obtain and track required preauthorizations and predeterminations.
Review claims for accuracy and completeness before submission.
Ensure timely electronic claims submission and processing.

Accounts Receivable & Insurance Follow-Up

Monitor outstanding insurance claims and accounts receivable.
Follow up on unpaid, delayed, denied, and underpaid claims.
Research claim denials, identify root causes, and submit corrected claims or appeals when appropriate.
Review insurance explanations of benefits (EOBs) and electronic remittance advice (ERAs).
Post insurance payments, contractual adjustments, and patient payments accurately.
Reconcile insurance payments against contracted reimbursement rates.
Identify and resolve claim processing discrepancies.
Maintain timely follow-up procedures to minimize aging accounts receivable.

Revenue Cycle Management

Monitor insurance collections, outstanding claims, and reimbursement trends.
Track and report key billing performance indicators, including:
Accounts receivable aging
Insurance collection rates
Claim denial rates
Clean claim submission rates
Days in accounts receivable
Outstanding claims over 30, 60, and 90 days
Identify opportunities to improve collections and reduce billing delays.
Collaborate with management to develop efficient billing processes.
Maintain accurate billing documentation and account notes.
Assist with month-end reporting and financial reconciliation.

Patient Accounts & Financial Coordination

Assist patients with insurance billing questions and account inquiries.
Explain insurance payments, adjustments, and outstanding patient balances.
Coordinate with treatment coordinators to ensure accurate treatment estimates.
Assist with resolving patient billing disputes professionally and efficiently.
Maintain patient confidentiality and HIPAA compliance.

Required Qualifications

Previous experience in dental or medical insurance billing.
Strong knowledge of insurance claims processing, reimbursement, and denial management.
Understanding of CDT, CPT, and ICD-10-CM coding.
Experience with insurance eligibility verification, preauthorizations, and claim appeals.
Knowledge of accounts receivable management and payment posting.
Excellent analytical, organizational, and problem-solving skills.
Strong attention to detail and accuracy.
Ability to work independently, prioritize tasks, and meet deadlines.
Proficiency with electronic claims processing and practice management software.
Strong written and verbal communication skills.

Preferred Qualifications

2+ years of oral surgery billing experience.
Experience billing both medical and dental insurance.
Knowledge of oral surgery coding for extractions, impacted teeth, dental implants, bone grafting, pathology, and anesthesia.
Experience with commercial insurance, Medicare, Medicaid, and Medicare Advantage billing, as applicable.
Familiarity with WinOMS or similar oral surgery practice management software.
Experience working with insurance clearinghouses and electronic remittance systems.
Certified Professional Coder (CPC), Certified Dental Coder (CDC), or other relevant billing certification preferred.
Demonstrated success reducing accounts receivable aging and improving insurance collections.

Pay: From $23.00 per hour

Benefits:

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

Work Location: In person

AZ Oral Facial and Implant Surgery

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