Adjudication, Billing, Claims Processing, Communication Skills, Dentistry, Documentation, Driver's License, Employee Relations, Healthcare Reimbursement, Insurance, Insurance Claims, Insurance Documentation, Leadership, Legal, Life Insurance, Mail Processing, Managed Care, Medicaid, Operational Communications, Oral Surgery, Orthodontics, Past Due Accounts, Patient History, Pediatrics, Preferred Provider Organization (PPO), Regulations, Regulatory Compliance, Time Management, Typing, Willing to Travel
We are Rodeo!
Rodeo Dental & Orthodontics is one of the fastest growing, multi-specialty dental groups in the country. The company’s team of 100+ award-winning doctors provide a full range of general dentistry, orthodontics, endodontics, oral surgery, and board-certified pediatric dental services in 40+ Rodeo locations throughout the states of Texas, Colorado, and Arizona.
The Biller - Appeals is responsible for reviewing any unpaid claims from the insurance plans. The appeal specialist follows up with the insurance company after 30 days of filing. Additionally, the appeal specialist will request reconsideration for payment for any denial claims that we have supporting documentation for payment.
QUALIFICATIONS:
- Knowledgeable with Dental Coding
- Knowledgeable with Dental Medicaid and PPO claim adjudication
- Knowledgeable with Dental Benefits and Verification of Coverages
- Knowledge of legal and regulatory provisions related to collection activities.
- Skilled with computer applications and fast typing.
- Ability to communicate with internal operations, patients, and insurance companies on all collection matters in a courteous manner.
- This position may require the employee to use his/her personal vehicle to travel to different work sites during the course of the work day, which means you would need an active, valid Driver’s License.
- Due to business, payroll, and compliance requirements, candidates must reside and be authorized to work at our Irving, Texas at the time of hire and for the duration of employment.
ESSENTIAL FUNCTIONS:
- Identifies delinquent accounts, aging periods, and payment resources
- Contacting patients for additional insurance information and resubmitting dental claims to appropriate dental payer.
- Reviewing Explanation of Benefits and patient history for accurate reimbursement and discounts by contracted managed care companies.
- Research and processes all rejected claims and resubmits with corrected information.
- Assists with processing insurance & patient refunds.
- Processes insurance related correspondence and responding timely to inquiries.
- Follow up with insurance companies ensuring that claims are paid on a timely basis by monitoring aging reports and open claims reports.
- Develops relationship with key personnel at the dental payers to obtain assistance with claim reconsiderations.
- Maintains strict confidentiality
- Performs all other duties as assigned
WHAT WE OFFER:
- New Grads, start your careers with Rodeo!
- Growth and advancement opportunities in our specialty dentistry business lines, such as orthodontics and oral surgery, as well as in leadership roles
- PTO
- Company-paid Life Insurance
- Medical
- Dental
- Vision
- Short-term and Long-term Disability
- Health Saving Account
- Supplement Life Insurance for you or your dependents
- 401(k)
- Accident
- Critical Illness
- Identity Protection
- Team Member Assistance Program
R
ROX Central Services Inc