UNIV - Dental Billing Specialist - College of Dental Medicine

30%:

• Review charges within Charge Review and Modifier Review work queues to identify coding, modifier, documentation, or billing issues that may affect accurate claim submission and reimbursement.
• Research and correct claim, charge, coding, and modifier errors through review of clinical documentation, EHR records, payer responses, and account activity.
• Perform account and chart audits to verify coding accuracy, account balances, claim integrity, and supporting documentation before billing follow-up or correspondence is completed.
• Post and reconcile insurance and patient payments, electronic remittances, and paper explanation of benefits (EOBs).
• Establish, monitor, and maintain payment plans for eligible patients in accordance with MUSC and CDM policies.
• Process claim corrections, reconsiderations, appeals, and resubmissions and provide supporting documentation when appropriate to resolve denials and support reimbursement.

30%:

• Respond to patients and responsible parties regarding account balances, billing questions, insurance claims, payments, and payment arrangements.
• Respond to patient MyChart messages and Secure Chat requests from CDM faculty, staff, and students regarding billing and patient account concerns.
• Monitor accounts receivable and perform timely follow-up on unpaid, denied, underpaid, rejected, and aging claims.
• Research claims incorrectly processed as out-of-network and work with participating insurance carriers to request correction or reprocessing when appropriate.
• Research missing insurance payments and remittances and initiate follow-up to ensure payments are properly identified, posted, and reconciled.
• Identify third-party payer payments, research deposited funds, and coordinate the transfer or correction of misapplied or misplaced payments to the appropriate patient account.
• Review and process paper and electronic correspondence requiring billing, payment, or claims follow-up and document actions taken within the patient account.
• Research and resolve credit balances, unapplied payments, and overpayments.
• Process appropriate refunds in accordance with MUSC and applicable State policies.
• Maintain complete and accurate billing, payment, claim, and accounts receivable records.
• Identify recurring account, denial, reimbursement, or collection trends and escalate significant concerns to leadership.

30%:

• Correct patient demographic, guarantor, coverage, and insurance information within the EHR when necessary to support accurate billing and claim adjudication.
• Perform insurance verification and identify eligibility, coverage, coordination-of-benefits, or other discrepancies requiring resolution before or during billing follow-up.
• Communicate timely and accurately with CDM faculty, residents, staff, and students regarding billing, insurance, and patient account issues.
• Prepare routine and ad hoc reports related to missing charges, charge review, unapproved charges, payment activity, accounts receivable, and billing trends.
• Assist leadership with escalated and complex patient account matters by researching account history, claims, payments, adjustments, documentation, and other relevant information and coordinating resolution.

10%:

• Serve as a resource and point of contact for CDM faculty, staff, and students regarding coding, billing, patient accounts, and related policies and procedures.
• Provide guidance and support regarding billing and coding processes, account resolution, and applicable CDM/MUSC procedures.
• Provide professional and courteous customer service to patients, responsible parties, payers, faculty, staff, and students while addressing billing questions, account concerns, insurance issues, and payment-related inquiries.
• Participate in assigned special projects, process-improvement initiatives, workflow development, and training activities.
• Perform other duties as assigned. 

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees