Pacific Dental Services
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at Pacific Dental Services
- Requisition ID
- Revenue Operations
- Location : External Name
- Pacific Dental Services
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.
Pacific Dental Services is an equal opportunity employer and does not discriminate against any employee or applicant for employment based on race, color, religion, national origin, age, gender, sex, ancestry, citizenship status, mental or physical disability, genetic information, sexual orientation, veteran status, or military status.