Revenue Cycle Coordinator Dental

Revenue Cycle Coordinator - Dental Billing

Department: Billing/Administration

Reports to: Revenue Cycle Manager Dental, COO and CFO

Non-Union Position

Full-time with benefits including Health, Dental, Vision, Life Insurance, Pension, Vacation, Sick, Holiday, and Personal Time

Pay Scale: $20.00 - $22.00/hour

The Revenue Cycle Specialist Dental is a key member and contributor to the success of the Practice. This “attention to detail” position provides in depth support for all insurance related duties of the office to ensure all treatment/procedures ordered by the provider are covered under the patient’s insurance plan. The Revenue Cycle Specialist will work closely under the supervision of the Revenue Cycle Manager – Dental and will provide support to the Revenue Cycle Medical/Behavioral Health/Public Health Team on a regular basis.

EDUCATION, EXPERIENCE AND SKILLS REQUIRED

● High School diploma or equivalent required.

● One year or more experience in Revenue Cycle/billing and claims adjudication required.

● Demonstrate effectiveness in written and verbal communication.

● Proficiency in Microsoft Office applications.

● Knowledge in Federal and State regulations.

● Accuracy and organization are a must.

● Familiarity with financial plans, Medicaid, Medicare and all private insurance companies.

● Strong organizational skills and communication skills required.

● Ability to maintain satisfactory working relationships with other employees and general

public is a must.

● Ability to be mobile without any limitations or restrictions

● Must be up-to-date on all immunizations and vaccinations

● Basic Life Support (BLS) certification or ability to obtain

● Must have a valid government-issued photo ID

ILLUSTRATIVE EXAMPLES OF WORK

● Assist in the resolution of claims with the goal of increasing revenue for the clinic

● Research and resolution of denials and unpaid claims to avoid loss of aged AR.

● Research and resolution of all outstanding Accounts Receivable

● Posting of EOBs will reflect the processing of the claim by the insurance carrier in such a way that balances may be forwarded to the next responsible party, and in a way that all denials can be monitored through reporting by use of line item reason codes.

● All EOBs posted will be scanned to create an electronic batch based on the date they were

posted

● Adjudication of all unpaid claims.

● Run reports regularly to indicate, via line item reason codes, what claims need re-worked to obtain further resolution based on how the claim denied.

● Run and complete required weekly and monthly reports to secure MCPHD’s financial health.

● Understands and monitors all business related function of the patient visit from point of entry to accurate adjudication of the patients’ accounts

● Adjudication of unpaid claims

● Unpaid claims report run regularly to show which claims have not yet been

processed by the billed insurance carrier. Claim status will be checked via phone call or

online options, and properly adjudicated based on the claim status

● Specific areas of responsibility include Revenue Cycle Training, Credentialing, Claims

Management, Billing, Collections, Patient Insurance, Date Processing, Integrity of Patient

Accounts, Accounts Receivable Management, practice management system file maintenance,

and third party revenue cycle vendors

● Responsible for provider reimbursement programs, policies, and strategies to ensure unit cost

controls meet or exceed corporate objectives for medical cost containment

● Analyzes claims, utilization, and dental cost data

● Meets internal goals and external benchmarks in the Revenue Cycle

● Resolves escalated reimbursement issues with payers and systems for optimal management of

account receivable

● Steps forward to address difficult issues

● Takes ownership and overcomes Revenue Cycle challenges.

● Develops, implements, maintains the Practice’s Revenue Cycle Standard Operating Procedures

(SOPs) for the Dental Department.

● May develop training materials to facilitate staff training of SOPs, systems metrics, government regulations, etc.

● Identifies new goals and visions to assist team in maximizing Revenue Cycle return.

● Processes all School Based Dental billing to maximize remittance on claims filed.

● Responsible for resolving overdue bills and collecting payment from the individuals responsible for the debt

● Performs other duties as required or assigned

Job Type: Full-time

Pay: $20.00 - $22.00 per hour

Benefits:

• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Experience:

• ICD-10: 1 year (Preferred)

Work Location: In person