Midwest Dental

Dental Insurance Specialist

US-WI-Mondovi
4 weeks ago
ID
2017-3199
# of Openings
1
Category
Insurance
Type
Full Time Regular

Overview

Midwest Dental supports great local dentists across the United States. Our culture of joy sets us apart from other dental organizations. Joy leads to better care, better ideas, and better outcomes. It creates wonderful patient experiences and rewarding careers.

 

Position Summary 

The Dental Insurance Specialist provides support to our dental offices by posting dental insurance payments and researching patient accounts to ensure the accuracy of posted payments. This position also focuses on processing denied dental insurance claims, researching and entering dental insurance profiles and fielding telephone calls from dental offices regarding insurance payments. 

 

 

Schedule (days/hours)

Monday-Friday

Responsibilities

Position Responsibilities

Claims

  • Review an explanation of benefit (EOB) and problem solve a situation to determine the dollar amount to be posted as well as determine applicable insurance adjustments and/or refunds

  • Posts and manages both primary and secondary insurance payments, while recognizing duplicate payments
  • Creates and submits electronic claims to insurance companies

  • Reviews rejected claims at the clearinghouse

  • Provides webinar and one on one training of correcting rejecting claims

  • Follows up on claims not submitted to the carrier correctly

Profiles

  • Corresponds with insurance companies regarding breakdown of dental benefits and create insurance profiles within dental system of record
  • Attaches insurance profiles to patient accounts
  • Updates treatment plans and resubmits any necessary claims

  • Follows up on any profile not calculating correctly

  • Hosts monthly webinars on how to set up profiles

Refunds

  • Reconciles patient accounts

  • Completes refund requests

  • Distributes refund to patient or insurance carrier

Communication

  • Builds relationships with dental offices via phone regarding patient balances and status of insurance claims
  • Communicates with insurance companies regarding how a dental claim was paid to determine the most appropriate application of the payment to a patient’s account

Administrative

  • Prints, scans and tracks EOB insurance claims

  • Sorts mail

  • Sends primary EOB to secondary insurance companies as needed

  • Copies, scans and shreds appropriate documents

  • Verifies batches that are scanned

  • Administers insurance website maintenance

Other duties

  • Follows all standard operating procedures
  • Adheres to HIPAA privacy policy

  • Will be expected to perform any and all related duties as assigned by manager

     

Qualifications

Education and/or Work Experience Requirements

High school diploma and one (1) or more years of relevant experience working with dental or medical insurance claims. One (1) or more years working in a dental office setting is preferred.  

 

Required Knowledge and Skills

  • Computer proficiency in Microsoft applications – Windows, Office, and Outlook
  • Excellent customer service skills
  • Attention to detail
  • Ability to problem solve
  • Ability to calculate figures and amounts

License and Certification Requirements

A valid Driver’s license

 

Physical Requirements and Working Conditions

Work is performed in a standard office environment.

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