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What Does a Dental Billing Specialist Do?

DentalPost takes a look at what are the duties and responsibilities of a Dental Billing Specialist.

Being a front office team member is one of the best careers Are you a job seeker interested in a part-time or full-time position as a dental billing specialist? Learn more about this lucrative career and how to get started.

Why Should You Become a Dental Billing Specialist?

As essential workers, dental and healthcare employees are in-demand now more than ever. If you are analytical and service-oriented with excellent communication skills, a career as a dental billing specialist might be for you. Here’s everything you need to know about what it takes to become a dental biller.

What Does a Dental Billing Specialist Do?

A dental billing specialist is in charge of managing payments for patients in a dental practice. By communicating with patients and dental or health insurance companies, a dental biller can request payments for services rendered.

Dental billers collaborate with the dental coder, dental assistant, dental hygienist, and dentist (DDS) to translate a dental care treatment plan and its corresponding billing codes to establish the amount owed from an existing or new patient. Billing specialists then reach out to insurance companies to negotiate reimbursement for claims. Specialists will also contact patients to provide payment reminders on an as-needed basis.

They research insurance plans to determine covered services, reimbursements, and out-of-pocket costs while advocating for claims approvals. Their duties include analyzing documents and submitting claims to insurers after treatment. Dental billing professionals also thoroughly document treatment plans, insurance, payment, and patient information for records keeping purposes.

Where Does a Dental Biller Work?

Some Dental billers work remotely as part of a virtual front office team post-Covid-19. However, a more conventional DDS may require you to work at the office front desk with other team members in the Dental Practice. If working from the dental office is mandatory, you’ll work closely with your office team members, such as the dental receptionist and the dental team.

What Experience Does a Dental Billing Specialist Need?

Depending on the dental front office, required years of dental experience can fluctuate. Some experience is transferable, such as prior experience in dental assisting or as another dental team member’s office job. Read through job postings to find an opening that suits your background and preferences.

Although years of experience are the best way to obtain any desired position, transferable experience may apply if the hiring manager allows it. Interchangeable knowledge from the office front desk can include years of experience as a dental office manager, office assistant, front desk receptionist, or front desk coordinator. If you have front office practice in family dental or orthodontics, be sure to list that information on your resume.

What Education and Training Does a Dental Biller Require?

Dental billing experts should have at least a high school diploma or GED to get their foot in the door. Similar to years of required experience, mandatory education and training requirements beyond high school will differ for each open position. Check your education and training against job postings and their listed qualifications to see if your education background is a good fit.

You may luck out and find a dental front office or office manager willing to provide on-the-job billing, coding, and office training. If you find the dental biller job of your dreams, but lack the mandatory education or training, check out one of the members-only certifications from the American Association of Dental Office Management (AADOM). Other certifications and educational opportunities should be available to you in your local community.

What Skills and Qualities Should a Dental Biller Have?

As you can imagine, every dental office is different. Consequently, their desired skills and qualities for a full-time candidate will vary. Most dental front office job descriptions will mention wanting excellent communication skills and customer service skills from the most qualified candidates.

If you’ve worked in any dental front office position, communication skills will serve you well when placing phone calls and managing complex situations. However, as a dental biller, you may need in-depth knowledge of medical services, such as x-rays and sedation, to land the position. You should be familiar with some medical and dental terminology with a working knowledge of most computer applications and customer management systems (CMS).

Check the job descriptions for contact information if you have additional questions regarding the job description.

Consider prior patient care experience as a full-time office manager, office assistant, Dental Assistant, Dental Receptionist, or any other front desk team member. If you’ve worked in these roles, you likely already have the skills needed for work as a Dental Billing Specialist.

Other required duties, skills, qualities, and qualifications may include:
  • Invoicing
  • Accounts receivable & payable
  • Claims handling
  • Payment processing
  • Data entry
  • Computer skills
  • HIPAA regulatory compliance
  • Active listening
  • Administrative support
  • Medical coding
  • Collections
  • Negotiation skills
  • Problem-solving
  • Medical coding
  • Account management
  • Documentation
  • Health care
  • Medical billing
  • Filing
  • Research
  • Analysis
  • Problem-solving
  • Time management
  • Bookkeeping
  • Accounting
  • Math

What to Expect as a Dental Biller

Dental billers work closely with the dentist, dental team, front office team, and dental or health insurance companies to coordinate efficient patient care and payment for these services. Most specialists work under a billing manager or clinical supervisor, depending on the practice size.

Billing specialists create detailed invoices, process payments, and keep accurate records for payment collections. Because most patients have some form of health or dental coverage, billers often mediate between the patient and their insurance company to coordinate and negotiate reimbursement payments for treatment.

If health or dental insurance companies deny a claim for whatever reason, a dental biller will file claims disputes and appeals on behalf of the patient. Keep in mind that if an insurance company denies a claim, direct patient billing applies. Expect to develop payment plans to assist patients with financial difficulties, particularly those experiencing Covid-19 hardship.

If you’re looking into positions related to a career as a billing specialist, joining a community of like-minded dental professionals can help. AADOM’s mission is to educate, connect, and empower dental staff across North America. Go here to join AADOM’s community of dental office experts today.

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