****MUST HAVE 4 years of Dental OFFICE BILLING with a proven track record on
collections. Also advanced knowledge in DENTRIX - A MUST****
********If you do not meet this requirement, please do not apply*************
We are seeking an Insurance Payment Coordinator to join our team!
The ideal candidate will be able to work in a fast-paced environment, is able to
multi-task or switch focus easily, and has experience reading an EOB or patient
account. Applicant must have the ability to take direction and interact smoothly
with different personalities and Maintain effective working relationships with
patients and team.
Essential Duties and Responsibilities
*Post insurance payments and insurance supplement payments
*Verify Insurance - provide a detailed breakdown when able
*Work as a team with treatment coordinator
*Post all insurance payments within 48 hours of receipt and prior to month end
*Post insurance capitation payments and capitation revenue
*Setup and maintain capitation payment accounts following standard guidelines for
account name, account type, and insurance record
*Monitor capitation payment accounts to ensure balance remains zero (both patient
*Monitor capitation trends data to ensure capitation transactions posted correctly
*Monitor capitation dollar trends by the office and plan to confirm receipt of
capitation payments; follow-up on missing payments to resolution
*Post unidentified payments to appropriate account (annual); include appropriate
documentation and maintain a file of all unidentified payments
*Research unidentified payments and resolve issues within 30 days of receipt.
*Post patient statement and collection letter payments
*Post ACH payments
*Generate secondary claim upon receipt of primary payment and attached primary
insurance carrier Explanation of Benefits (EOB)
*Adjudicate claim payments and process adjustment per insurance carrier Explanation
of Benefits (EOB) up to approved amounts.
*Write up adjustments over approved amounts and provide to the manager for review
*Enter notes in patient’s ledger and claim systems; providing details regarding
payment denial, short pay or patient copay responsibility
*Copy part paid EOB’s requiring appeal and distributed to insurance collectors.
*Scan payment EOB (Explanation of Benefits), confirm readable and searchable; store
in a folder for dental office and billing office access.
*Balance and prepare deposits and cash audit reports
*Assist the mail team when required
*Check DENTRIX for Posting Errors
*Complete understanding of Adjudication of Dental Health Claims, Coordination of
benefits (COB), and Dental Code Sets.
*Understanding of Pricing and Authorizations
*Must have the personality that is able to speak up and give direction
* Clear understanding of dental benefit structures.
*Excellent written skills and oral communication skills
*10 key by touch *Must pass drug and background check