• Oversee the operation of the billing processes, encompassing dental/medical coding, charge entry, and claim submission
• Follows up with third-party insurance carriers on unpaid claims till claims are paid or only the self-pay balance remains
• Processes rejections by either making accounts private pay and generating a letter of rejection to patients or correcting any billing error and resubmitting claims to third-party insurance carriers
• Keeps updated on all billing and benefit changes for third-party insurance carriers
• Maintains strictest confidentiality and adheres to all HIPAA guidelines/regulations
• Helping patients to gain a greater understanding of their treatment and their dental health plans
• Manage the financial commitments associated with their care, along with any future appointments they may need to manage their dental health
• Effectively communicating treatment plans, and any changes in treatment plans
• Answering questions related to treatment plans to get approval for services
• Coordinating insurance benefits and making financial arrangements
• Verifying insurance options and limitations
• Booking appointments, answering general questions, and offering other associated support

Skills: Billing Management, Claim Submission, Coding Knowledge, Insurance Follow-Up, HIPAA Compliance, Treatment Communication, Financial Coordination, Appointment Booking

• Serve as the point person for all Exclusive Provider Network (EPN) inquiries from current and potential providers
• Facilitating conversations between Aetna and providers
• Update financial documents to reflect current costs and projections
• Onboard new EPN providers
• Manage the university fleet safety program
• Obtain familiarity with the University Fleet Safety Policy and provide backup support to the Director in responding to questions
• Issues and acting as the primary contact to all fleet safety representatives
• Manage property/casualty insurance program
• Prepare, process and maintain departmental financial records related to P/C program premium payments and associated expenses, to include the monthly review and reconciliation of all expense reports
• Maintain the University Property Schedule of Values, providing updates to the applicable carrier
• Perform the annual allocation of the auto insurance premiums and programmatic costs and the property program-related premium and programmatic costs
• Conduct claims analysis and reporting
• Manage the certificate of insurance program
• Maintain electronic database and provide administrative support

Skills: EPN Management, Provider Onboarding, Financial Updates, Fleet Safety, Insurance Program, Claims Reporting, Database Maintenance, Admin Support

• Verifies patient insurance benefits, including treatment-specific benefits, by utilizing insurance websites or calling insurance companies
• Documents pertinent information and efforts in the computer system based on department documentation standards
• Coordinates approval process for patients to ensure that UT Southwestern Medical Center referral, medical review and billing policies and procedures are followed
• Coordinates ongoing pre-certification and approval process with insurance case managers and provides clinical updates 
• Protects the privacy and security of patient health information to ensure that confidentiality is maintained
• Provides patient education regarding the financial aspects of services rendered
• Coordinate with the clinical financial counselor to assist patients with the financial aspects of services rendered
• Advises physicians and other medical staff regarding insurance benefits and the financial clearance status of patients
• Meets with patients and their families to discuss potential out-of-pocket expenses related to treatment-specific services rendered
• Coordinates the financial/registration process for cases and coordinates the flow of information to the appropriate departments regarding patients
• Provides notification to hospital and physician billing departments regarding the admission process for patients
• Creates treatment-specific insurance coverage in the registration area of the electronic medical record
• Provides information to appropriate parties to ensure patients are registered and billed correctly
• Assists the billing department with appeals 
• Develop personal and professional goals for themselves and will provide opportunities for continued growth and development

Skills: Insurance Verification, Benefit Coordination, Precertification Process, Patient Education, Financial Counseling, EMR Updates, Billing Support, Confidentiality Compliance

• Act as a liaison between the facility and payment parties to investigate the claim
• Verify its information, and update the database in the event that a claim is denied by the third-party payer
• Receive and review patient charts and documents for accuracy
• Ensure that all codes are current and active
• Report missing or incomplete documentation
• Meet daily coding production
• Update and maintain document lists
• Performs accurate charge entries
• Ensure proper coding on provider documentation
• Serves as a resource regarding insurance resolutions and coding questions
• Handles co-pays, balances, and charge posting

Skills: Claim Investigation, Data Verification, Chart Review, Coding Accuracy, Charge Entry, Documentation Review, Insurance Resolution, Payment Posting

• Follows coding guidelines and legal requirements to ensure compliance with federal and state regulations
• Review patient medical records
• Coding treatment information using Current Procedural Terminology (CPT) codes
• Communicating with medical billing specialists to ensure treatment codes are accurately received
• Liaise and support other members of the multi-disciplinary team and other agencies relating to patient care, maintaining good communication channels
• Assess, plan, develop, implement and evaluate programmes to promote health and well-being
• Be aware of safeguarding policies, both local and national, and implement such policies 
• Recognize and refer patients presenting with holistic health needs, including mental illness
• Assess clinical conditions, prioritize health problems and intervene appropriately, including initiation of effective emergency care
• Manage own patient caseload, including the interpretation of test results and the ability to act upon these

Skills: Coding Compliance, Medical Review, CPT Coding, Billing Coordination, Team Communication, Health Promotion, Safeguarding Awareness, Caseload Management

• Prior dental office experience 
• Must possess excellent written and verbal communication skills
• High school diploma or equivalent
• Outstanding positive attitude and demeanor
• Strong interpersonal and relationship-building skills
• Knowledge of all company policies and rules
• Ability to multitask and work in a fast-paced environment
• Able to establish and maintain effective working relationships with staff, faculty, and others
• Able to work independently and plan day-to-day activities
• Able to make complex mathematical calculations
• Able to create complex Excel spreadsheets that incorporate mathematical formulas

Qualifications: BA in Communication Studies with 5 years of Experience

• Experience with Tableau and the PeopleSoft financial system
• Experience in a dental setting
• Experience with insurance billing and accounts receivable
• Experience in coordinating benefits
• Thorough knowledge of principles or organization, administration, and management, practices and regulations as they pertain to travel
• Thorough knowledge of state and federal employment laws, rules, regulations, and collective bargaining procedures
• Ability and specialized skills to communicate clearly and effectively, both orally and in writing
• Able to work well under pressure and in constantly changing circumstances, and interact with personnel in a highly professional manner
• Ability to work with a population from diverse backgrounds
• Ability to maintain confidentiality

Qualifications: BA in Healthcare Administration with 4 years of Experience

• Familiar with Basic Medical Terminology
• Experience with Electronic Medical Record Systems
• Knowledge of Medical Insurance, Medical Insurance Billing, and Medical Insurance Verification
• Experience doing insurance verification or reimbursement in a healthcare or pharmacy setting
• Working experience in database maintenance 
• Excellent verbal and written communication skills
• Outstanding customer service skills
• Proficiency in Microsoft Office applications (Word, Excel, and PowerPoint)
• Ability to prioritize and multitask
• Must have strong organizational skills
• Strong leadership qualities and accounting skills
• Experience with accounts receivable

Qualifications: BS in Medical Billing and Coding with 6 years of Experience

• Experience in medical billing and collections
• Knowledge of Medicaid benefits
• Proficiency in Microsoft Office Suite
• Must have strong interpersonal skills
• Must be able to communicate effectively, both in writing and in verbal communication
• Excellent data entry and organization skills
• Excellent time management and collaboration skills
• Possess personal effectiveness and credibility
• Ability to work with minimal supervision
• Ability to appropriately handle confidential and highly sensitive information in a trustworthy manner

Qualifications: BS in Health Information Management with 3 years of Experience

• Experience working in a metrics-driven environment
• Ability to perform work accurately and completely, and promptly
• Ability to deliver quality through attention to detail
• Ability to learn and use a variety of software, tools and systems necessary to meet business needs
• Knowledge of construction industry terminology and documents
• Knowledge of administrative, office and general risk management procedures and standards 
• Ability to quickly and effectively solve complex problems
• Knowledge of organizational structure and available resources
• Ability to build relationships and collaborate within a team, internally and externally
• Excellent communication, interpersonal and organizational skills
• Provide legendary customer service and maintain retention
• Proficient in using Microsoft Office software products

Qualifications: BS in Business Administration with 7 years of Experience