Medicaid Billing Operations Specialist

Overview:

This position is responsible for processing dental claims, managing accounts receivable, posting payments, and ensuring the accuracy of financial transactions. The ideal candidate must have strong communication skills, as they will be responsible for fostering relationships with clients, patients, and insurance providers to ensure a smooth billing and payment process. A solid understanding of dental insurance billing, claim follow-ups, and cash reconciliation to support the financial operations of our practice.

• Serve as a contact for contracted facility personnel by communicating regularly with facility contact, territory marketers, and local operations and management.
• Must be familiar with the IME refund process.
• Educate Business Office Managers on how to effectively manage and process IME claims through the TX HHSC program.
• Check eligibility and benefit verification.
• Review patient bills for accuracy and completeness and obtain any missing information.
• Prepare, review, and transmit claims using billing software.
• Follow up on unpaid claims within standard billing cycle time frame following prescribed methods.
• Keep the facilities updated on any process changes along with re-education.
• A commitment to excellent customer service.
• Actively supports and complies with all components of the compliance program, including, but not limited to, completion of training and reporting of suspected violations of law and Company policy.
• Maintains confidentiality of all information; abides with HIPAA and PHI guidelines at all times.
• To work remotely, it is expected you will have a reliable, nonpublic high-speed internet connection with sufficient bandwidth to participate in all work-related activities. Any interruptions in service should be immediately reported to your manager.  
• Reacts positively to change and performs other duties as assigned.

• Associate’s degree preferred, or equivalent experience.
• Minimum of 5 years’ account management or Business Office Management experience required.
• Experience with dental billing software.
• Front or back office medical/dental experience.
• Proficiency with Microsoft Office required.
• Critical thinking/Solutions-based skills required for a time sensitive environment.
• Strong and effective communication and interpersonal skills, including proven ability to build relationships, speak publicly and communicate persuasively.
• Strong time management skills and ability to multi-task
• Ability to lead colleagues, manage multiple priorities and achieve results.
• Exceptional organizational, analytical, and problem-solving skills
• Must be self-directed and able to meet deadlines.
• Ability to work independently and with other team members.
• Excellent interpersonal, oral, and written communication skills.
• Must be detail oriented and self-motivated.
• Excellent customer service skills.
• Anticipate needs in a proactive manner to increase satisfaction.
• Take ownership of job responsibilities by initiating prompt and appropriate follow up and/or action to problems.

We will only employ those who are legally authorized to work in the United States. Any offer of employment is conditional upon the successful completion of a background investigation and drug screen.