To effectively and efficiently apply for pre-authorization of orthodontic dental services filed on behalf of patients with various insurance companies and perform any necessary follow-up and collections activities for those services. Contact is made by telephone and/or computer. Duties include providing treatment plan information and clinical details to the appropriate insurance company to request prior approval from the insurance company before services are performed.
Essential Duties and Responsibilities
The Ortho Billing & Collections Agent performs many tasks requiring both interpersonal and technical skills.
Duties and Responsibilities:
- Confer with insurance company representatives by telephone and/or computer to provide relevant patient information to the insurance company regarding pre-authorization of treatment plans, follow up on status of request, application of payments when services are billed, and collection activities after services are submitted for payment.
- Locate and monitor records using computers and a variety of automated systems.
- Record information about status of submission efforts.
- Sort and file correspondence and perform miscellaneous clerical duties, such as answering correspondence and writing reports.
- Perform various administrative functions for assigned accounts, such as recording responses to requests and following up with any additional information.
- Contact insurance companies to check on status of submissions and write appeal letters for denial on claims.
- Other duties as may arise.
Knowledge, Skills, and Abilities
- Knowledge of principles and processes for providing customer service. Previous dental experience is a plus.
- Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, and other office procedures and terminology.
- Ability to work in fast paced environment.
- Detail oriented. Must be aware of and follow state specific rules and protocols.
- Active Listening skills. Must be able to give full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate.
- Deductive Reasoning skills. The ability to apply general rules to specific problems to produce answers that make sense.
- Time Management Skills to manage one’s own time.
- The ability to communicate information and ideas in writing so others will understand.
- Management of Human Resources. Motivating, developing, and directing people as they work, identifying the best people for the job and addresses performance issues as they arise.
- Communicating with people outside the organization, representing the organization to customers, the public, government, and other external sources. This information can be exchanged in person, in writing, or by telephone or e-mail.
- Performing day-to-day administrative tasks such as maintaining information files and processing paperwork.
Qualifications (Experience, Education, License, Certification)
- High School diploma or equivalent required. Will consider relevant work experience.
- 2-3 Years of related work experience preferred.
- Excellent computer skills including MSOffice and practice management software. Entering, transcribing, recording, or maintaining information in written or electronic form
- Excellent organizational skills and attention to detail.
- Excellent communication skills.
- Job requires being honest and ethical.