Pacific Dental Services

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Job Details

Medical Biller

at Pacific Dental Services

Posted: 2/6/2019
Job Reference #: 6904

Job Description

  • Job LocationsUS-NV-Henderson
    Requisition ID
    Revenue Operations
    Location : External Name
    Henderson Support Center
  • Description

    Now is the time to join Henderson Support Center. You will have opportunities to learn new skills from our team of experienced professionals. If you're ready to take your career to the next level and gain valuable experience, apply today!


    The Medical Biller will be responsible for the processing of all Medical claims electronically. Such responsibilities include but are not limited to auditing, tracing and processing appeals for erroneous denials or inaccurate reimbursement of medical claims.

    - Processes encounters that includes CPT, HCPCS, and ICD-10 codes for daily medical billing.
    - Confirms appropriate CPT, HCPCS, and ICD-10 to ensure compliance and reimbursement accuracy.
    - Act as a liaison between the CBO (Central Business Office) department, dental billers, and third party payers in resolving billing and reimbursement accuracy.
    - Processes medical claim appeals.
    - Attains required information to ensure payment claims are sent out with supporting documentation.
    - Audits electronic claim reports by validate CPT, HCPCS, and ICD-10 discrepancies and makes the appropriate corrections required for claims to be sent electronically. Requests any additional information from office that is needed to make the corrections.
    - Generates weekly reports for unbilled encounters and ensures insurances are billed in a timely manner.
    - Reviews and sends out re-submittals for appeals.
    - Prepares and performs written reports of all accounts for tracing.
    - Audits and traces medical claims to ensure timely and accurate reimbursement.
    - Collaborates with the Auditor and Claim tracer for processing Dental claims.
    - Files and follows up for Third Party medical claims.
    - Processes requests via email from offices in the field including filling dental services to medical payers and benefits and eligibility ? precertification of specialized services.
    - Processes attachments through NEA.
    - Provides customer service to the affiliated dental and medical practices of PDS, through the call center, as well as email.
    - Other duties as assigned by management.

    - Equivalent to high school diploma or general education degree (GED).
    - +6 years experience in dental or medical billing

    - Bachelor?s or Associate?s Degree from an accredited college.
    - Knowledge of QSI, NextGen
    - Customer Service Certificate program

    - One to two years of Customer Service Experience preferred.
    - Strong computer skills and demonstrated competence in MS Office, Word, Excel software applications.
    - Knowledge of CPT, HCPCS, and ICD-10-CM codes.
    - Knowledge of medical terminology, basic anatomy, physiology, and disease process.
    - Knowledge of Medicare and Medicaid rules and regulations.
    - Ability to read, analyze, and interpret common financial reports, and legal documents. Ability to respond to common inquiries from customers, staff, regulatory agencies, vendors, or other members of the business community.
    - Ability to multi-task effectively without compromising the quality of the work.
    - Excellent interpersonal, oral and written communication skills.
    - Detail oriented, organized, process focused, problem solver, proactive, ambitious, customer service focused.
    - Strong sense of personal responsibility for tasks assigned; ability to work with others & accept direction.
    - Ability to draw conclusions and make independent decisions with limited information.
    - Ability to respond to common inquiries from customers, staff, regulatory agencies, vendors, and other members of the business community.
    - Self-motivated, reliable individual capable of working independently as well as part of a team.
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    Application Instructions

    Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!