Position Class Code/Title: B0026 / Dental Billing Tech
BEST CONSIDERATION DATE: OPEN UNTIL FILLED
UNM Medical Group, Inc. (UNMMG) is the practice plan organization for physicians and other medical providers associated with the UNM Health Sciences Center. UNM Medical Group, Inc. is a New Mexico non-profit corporation and is an equal opportunity employer. UNMMG offers a competitive salary and an attractive benefit package which includes medical, dental, vision, and life insurance as well as tuition assistance, paid leave and 403b retirement for benefits eligible employees.
The Department of Dental Medicine is seeking a highly motivated individual to work as a Dental Billing Tech for all our clinics. This position will be working in the dental billing office presenting treatment plans to patients, processing prior authorizations, claims, posting payments, researching denials, resubmitting claims, reconciliation of general ledgers, and working the collections list for outstanding account balances
The following statements are intended to describe, in broad terms, the general functions and responsibility levels characteristic of positions assigned to this classification. They should not be viewed as an exhaustive list of the specific duties and prerequisites applicable to individual positions that have been so classified .
Performs a variety of complex clerical and accounting functions for patient billing, including verification of invoice/billing information, maintenance of third party billing records, and resolution of a variety of problems. Follows up on submitted claims and patient billing; resubmits claims or resolves problems. Researches and analyzes delinquent third-party payer claims, determines reimbursement problems, and adjusts and resubmits claims. May handle cash items and accounts receivable posting.
DUTIES AND RESPONSIBILITIES
- Processes billings to patients and third party reimbursement claims; maintains supporting documentation files and current patient addresses.
- Processes patient statements, keys data, posts transactions, and verifies accuracy of input to reports generated.
- Researches and analyzes third-party payor claims such as Medicare, Medicaid, Tricare, Managed Care, Workers Compensation, Indian Health Service, and various commercial insurance; verifies patient eligibility, adjusts and resubmits claims.
- Researches and prepares billings for initial electronic claims submissions.
- Researches and responds by telephone and in writing to patient inquiries regarding billing issues and problems, and explains insurance coverage to patient.
- Responds by telephone or correspondence to inquiries from patients/third party payers; researches problems, and corrects errors.
- Follows up on submitted claims; monitors unpaid claims, initiates tracers; resubmits claims as necessary.
- Balances daily batches and reports; prepares income reports and statistics; distributes reports.
- Performs daily and monthly reconciliations to the general ledger, to include reclassifications; receives and balances documents of deposits received, and distributes remittance advices.
- Reviews and interprets operational data to assess need for procedural revisions and enhancements; participates in the design and implementation of specific systems to enhance revenue and operating efficiency.
- Maintains patient demographic information and data collection systems.
- May receive and receipt cash items and third party reimbursements; posts and reconciles payments to patient ledgers.
- Participates in development of organization procedures and update of forms and manuals.
- Performs a variety of general clerical duties, including telephone reception, mail distribution, and other routine functions.
- Maintains statistical data and records; may prepare regularly scheduled or special reports on dental/medical claims.
- May perform data entry, answer telephones, and assist with walk-in inquiries.
- Follows established departmental policies, procedures, and objectives, continuous quality improvement objectives, and safety, environmental, and/or infection control standards.
- Ensures strict confidentiality of financial records.
- Performs miscellaneous job-related duties as assigned.
MINIMUM JOB REQUIREMENTS
High school diploma or GED; at least 3 year of experience that is directly related to the duties and Responsibilities specified. Verification of education and licensure (if applicable) will be required if selected for hire.
KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED
- Demonstrated skill in resolving dental/medical payment issues with third-party payer groups.
- Ability to gather data, compile information, and prepare reports.
- Ability to communicate effectively, both orally and in writing.
- Analytical and problem solving skills.
- Ability to maintain confidentiality of records and information.
- Knowledge of dental and medical terminology, ICD-9, CPT coding, CDT coding, and ADA diagnosis and procedure coding.
- Thorough working knowledge of dental and medical billing, accounts receivable, and payment reconciliation.
- Knowledge of EagleSoft, AxiUm or other dental software program payment and adjustment processes.
- Ability to make administrative and procedural decisions and judgments on sensitive, confidential issues.
- Demonstrated skills in the use of personal computers and medical software.
- Working knowledge of electronic data interchange (EDI) reimbursement procedures and systems.
CONDITIONS OF EMPLOYMENT
- Must be employment eligible as verified by the U.S. Dept. of Health and Human Services Office of Inspector General (OIG) and the Government Services Administration (GSA).
- Must pass a pre-employment criminal background check.
- Fingerprinting, and subsequent clearance, is required.
- Must provide proof of varicella & MMR immunity or obtain vaccinations within 90 days of employment.
- Must obtain annual influenza vaccination.
- If this position is assigned to a clinical area, successful candidate will be required to complete a pre-placement medical evaluation/health screen. Required N-95 mask fitting, testing, vaccinations to include annual TST, Tdap, and Hepatitis B will be determined based on location and nature of position.
WORKING CONDITIONS AND PHYSICAL EFFORT
- Work is normally performed in a typical interior/office work environment.
- No or very limited exposure to physical risk.
- Moderate physical activity. Requires handling of average-weight objects up to 25 pounds or standing and/or walking for more than four (4) hours per day.