Position Summary:
Job incumbent manages and guides internal dental billing processes, in coordination with the Reno-Sparks Tribal Health Center’s business office and associated Revenue Cycle Management team; oversees patient self-payments, various funding sources, and third-party dental prior authorizations; resolves dental claim denials and follow up; and provides case management assistance for all dental patients referred to outside providers.
All employees of the Reno-Sparks Indian Colony must adhere to a model of service and guiding principle which requires providing timely and effective assistance with the ability to interact with others in a way that inspires trust and demonstrates respect, compassion, and empathy.
Essential Functions: This list is ILLUSTRATIVE ONLY and is not a comprehensive listing of all functions and tasks performed by incumbent.
Duties:
- Clearly explaining and exploring all treatment options, related costs, and funding sources for dental treatment
- Ensuring all dental insurance accounts are correctly established within practice management software (guarantor, demographics, addresses, etc.) and that all current dental providers are correctly paneled with all active insurance companies
- Assisting in credentialing or recredentialing of dental providers as needed to ensure all active dental providers are correctly paneled with insurance companies
- Resolving dental claim denials with insurance and resubmit as appropriate including any requested information
- Reviewing patient accounts for accuracy and completeness
- Daily electronic claims follow up and submission of all radiographs, periodontal charting or documentation requested from the insurance companies through Fast Attach, Dentalxchange, OR similar system
- Sending and receiving insurance prior authorizations and patient responsibility estimates
- Working with the front desk to ensure timely scheduling of all pre-authorized treatment
- Developing and maintaining systems such as forms and checklists to verify workflow and streamline patient care
- Monitoring dental coding practices to ensure proper coding for maximum reimbursements
- Tracking patients who have pending and incomplete treatment
- Being the point-of-contact for the RSTHC Orthodontic Program. This includes monitoring and tracking program patients, ensuring paperwork is completed, Orthodontic office is informed, patients are following up with appointments, and handling requests from both patients and the Orthodontic office
- Dental Specialty Referral Case Management (in collaboration with the referral staff) including assisting with finding a specialist, making appointments, procuring post-consult/treatment documents, dental charting, and managing the referrals within the electronic health record
- Reconciling outside lab statements, invoices and payments
- Providing daily, monthly, or as needed dental reports as requested
Minimum Qualifications:
- Must be a High School Graduate (or GED recipient)
- Minimum five years of work experience in the dental field
- Minimum two years of work experience with dental or medical insurance billing
- Must be highly computer literate and be willing to be trained on new software as needed
- Must be a self-motivated individual and have strong oral, written, and interpersonal skills
- Must have the ability to adapt to a fast-changing environment
- Must be able to work in a “Team” environment, in limited space with shared work areas
- Must have knowledge and ability to adhere to Health Insurance Portability and Accountability Act (HIPAA), the Health Information Technology for Economic and Clinical Health Act (HITECH), and 42 CFR Part 2 confidentiality regulations
- Must maintain strict confidentiality
- Preferred knowledge of AAAHC, OSHA, and CDC infection control standards
- Must have a current CPR/BLS certificate prior to date of hire
- Must be able to work in a diverse minority environment
- Must provide evidence of a recent Infectious Pulmonary Tuberculosis (TB) test showing ONE of the following: 1) a negative Mantoux skin test 2) a negative chest x-ray or 3) a statement from a physician confirming freedom from TB.
- Indian Preference applies
Job Type: Full-time
Pay: $20.05 - $24.66 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
People with a criminal record are encouraged to apply
Work Location: In person
