Insurance Follow-up Specialist (Remote)
About the position
Responsibilities
• Perform accurate and timely claims follow-up and resolution.
• Adhere to government regulations, payor contracts, and third-party guidelines when resolving open balances and denials.
• Analyze authorizations, claims, and explanation of benefits to identify next steps for payment resolution.
• Contact patients or payor representatives to resolve claims and coordinate benefits.
• Collaborate with Revenue Cycle Specialists and Corporate Training Teams to identify denial trends.
• Notify Manager of insurance plan denials that should be covered based on contract terms.
• Research payor and government websites to identify claim requirements for resolution.
• Document all follow-up and resolution activities in the practice management system.
Requirements
• High School Diploma or equivalent; Associates or Bachelor's Degree preferred.
• At least three (3) years of dental bill generation and claims processing experience.
• Expertise in government, commercial, and/or third-party payor claims submission, denial resolution, and appeals processes.
• Knowledge of dental claim requirements and ability to interpret billing guidelines.
• Experience with Dentrix Core and Ascend PMS systems.
• High attention to detail and accuracy.
Nice-to-haves
• Experience with Microsoft Word and Excel.
• Knowledge of CDT and ICD coding systems.
Benefits
• Remote work flexibility
• Equal Opportunity Employer
• Support for a diverse workforce
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