Claims Coordinator

This is a fully remote position, open to applicants in United States.

📋 Description

• Ensure the precise and prompt submission of dental claims for designated offices.

• Analyze Accounts Receivable reports and follow up on pending insurance claims and balances.

• Examine clinical notes, x-rays, and account ledgers for consistent information.

• Generate and file electronic and paper claims with necessary attachments, including orthodontic claims.

• Submit claims through the clearinghouse and address any invalid or rejected claims.

• Dispatch claims within 48 hours following the date of service.

• Communicate account and claim concerns to dental offices or assigned team members and monitor required corrections.

• Process corrected claims triaged by the AR Specialist.

• Liaise with insurance companies regarding claim issues and non-payments.

• Handle appeals and fulfill requests from insurance companies.

• Review returned EOBs, including denials, missing information, attachments, corrected claims, and retractions.

• Monitor outstanding insurance balances by category and report completion to the OM.

• Engage in special projects and assigned duties.

• Provide coverage for other Claims/AR Coordinators as necessary.

• Assist in and deliver training for new CBO team members.

• Participate in and contribute to monthly meetings.

• Report any grievances or issues to CBO-RCM.

⛳️ Requirements

• Prior experience in dental office administration, dental billing, or insurance claims processing is highly advantageous.

• Experience in medical claims processing may also be taken into account.

• Acquaintance with dental terminology and procedures.

• Comprehension of dental insurance policies, coverage limitations, and claim submission protocols.

• Familiarity with standard insurance codes, including CDT codes, and ADA dental claim forms.

• Detail-oriented in claim review and discrepancy detection.

• Excellent verbal and written communication skills.

• Capacity to manage and prioritize multiple responsibilities.

• Proficient with dental practice management software and other computer applications used for claim processing and administrative functions.

• Strong customer service skills for addressing billing and insurance inquiries.

• Ability to resolve claim-processing issues, billing errors, and discrepancies in insurance coverage.

• Knowledge of and compliance with HIPAA and legal and ethical billing standards.

🏝️ Benefits

• Competitive salary and performance-based incentives.

• Comprehensive health insurance plans.

• Opportunities for professional development and career advancement.

• A supportive work environment with a collaborative team.