Insurance Follow-up Specialist (Remote)

About the position

The Insurance Follow-up Specialist plays a crucial role within the Revenue Cycle Team at Elite Dental Partners, focusing on the timely submission and resolution of dental claims in compliance with government regulations and payor guidelines. This position is responsible for ensuring accurate claims follow-up, resolving denials, and appealing claims to enhance revenue flow and minimize write-offs.

Responsibilities
• Perform accurate and timely claims follow-up and resolution.
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• Adhere to government regulations, payor contracts, and third-party guidelines when resolving open balances and denials.
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• Analyze authorizations, claims, and explanation of benefits to identify next steps for payment resolution.
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• Contact patients or payor representatives to resolve claims and coordinate benefits.
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• Collaborate with Revenue Cycle Specialists and Corporate Training Teams to identify denial trends.
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• Notify Manager of insurance plan denials that should be covered based on contract terms.
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• Research payor and government websites to identify claim requirements for resolution.
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• Document all follow-up and resolution activities in the practice management system.

Requirements
• High School Diploma or equivalent; Associates or Bachelor's Degree preferred.
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• At least three (3) years of dental bill generation and claims processing experience.
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• Expertise in government, commercial, and/or third-party payor claims submission, denial resolution, and appeals processes.
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• Knowledge of dental claim requirements and ability to interpret billing guidelines.
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• Experience with Dentrix Core and Ascend PMS systems.
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• High attention to detail and accuracy.

Nice-to-haves
• Experience with Microsoft Word and Excel.
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• Knowledge of CDT and ICD coding systems.

Benefits
• Remote work flexibility
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• Equal Opportunity Employer
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• Support for a diverse workforce

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