What are the responsibilities and job description for the Orthodontic Billing Specialist position at SBH Health System?
1. Promote a safe, cooperative and professional health care environment to ensure optimum patient care (as per HR Policy 113c).
2. Adheres to all hospital policies, procedures, rules and regulations, including but not limited to, absenteeism, ETIME, cellular telephone usage, dress code and rules of conduct.
3. Makes Customer Service a priority, treating customers (patients, visitors, and co-workers) in a professional manner exercising courtesy and tact. Effectively communicates with patients and others about SBH services in their area(s) of expertise or responsibility and ensures that concerns, questions or issues reach the right person(s) in SBH in a timely fashion.
4. Demonstrates the standards of performance and behaviors consistent with the DRIVE to Patient-Centered Excellence.
5. Submit accurate and timely Pre-Authorization requests and claims to insurance companies.
6. Verify patient insurance coverage and benefits and communicate them in a timely manner to others involved in the care of the patient.
7. Collect and Post insurance payments / adjust patient accounts.
8. Follow up on denied pre-authorization requests and claims and resubmit or appeal as needed.
9. Handle patient inquiries regarding billing and insurance.
10. Maintain patient confidentiality in accordance with HIPAA regulations.
11. Ensure high attention to detail while multitasking in a busy office environment.
12. Remain knowledgeable and current with changing insurance coding requirements and keep the relevant teams informed
13. Track for changes in patient coverage and submit Continuation of Care (COC) request as needed and in a timely manner.
14. Inform patients when insurance benefits expire or are terminated and facilitate transition to a self-payment contract when appropriate.
15. Produce routine reports on collections and production and submit to direct report in a timely manner.
- Education Required
- Bachelors or Associates Preferred. Previous office / insurance background and / or business-related course preferred
- License / Certification / Registration(s) Required
- Certified Medical Billing Preferred
- Experience / Skills Required
- At least two years of experience in dental billing, with a focus on orthodontics.
- Knowledge of dental terminology and procedures.
- Epic / Wisdom knowledge preferred
- Strong attention to detail and organizational skills.
- Excellent communication and customer service skills.
- Proficient in Word, Excel, and Outlook
- Multilingual preference, at least English and Spanish
