To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values-integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
Provides a wide variety of billing, collections, and business management services associated with the daily billing operation of the dental department to provide departmental efficiency and financial stability to achieve goals.
Responsibilities: 1. Establishes financial viability of all patients to ensure proper reimbursement and reporting to department and follows through until account is closed. 1.1 Prepares and submits electronic claims to participating insurances carriers. Insuring accuracy of submitted information. Initiates and verifies procedure codes entered into the system. Resolves denied claims by reviewing denials, obtaining additional documentation, verifying/correcting codes submitted on the original claim and re-submitting claim to the insurance company for payment.
1.2 Posts all patient services and payments daily. 1.3 Establishes payment plans using Eaglesfot software system. Discussies payment options with patients and establishes payment plan when indicated. 1.4 Communicates with patients to determine patient insurance status. Contacts the patient''s insurance carrier to determine coverage available. Discusses payment options with patients with no insurance including: self-pay, state assistance, including information on how to apply for assistance, and/or communicate the free-care program at YNHH.
1.5 Handles inquiries from patients and insurance carriers concerning patient account status and responds approprately. When indicated and/or requested by the said party, the manager is to be consulted.
Performs collection duties on self-pay patient accounts past due (up to 90 days) including collection calls and collection letters.
1.6 Prepares and makes daily cashier deposits, to balance with daily Eaglesoft postings. Reconciles accounts and deposits to ensure accurate posting to appropriate accounts. Reconciles bundled payments from the State of Connecticut and posts the appropriate payment amount to patient accounts.
1.7 Runs and reviews electronic reports to ensure accurate billings and collections.
1.8 Cross references those patients who have been approved for Free Care and Sliding Scale. Applies the appropriate policy to the patient''s account and assigns the patient the appropriate billing type in the Eaglesoft system. 1.9 Submits and reviews pre-determinations of benefits to Title 19 and private insurances, communicating results to both the provider and patient as indicated. 1.10 Reviews laboratory charging and billing statements for all prosthetic cases insuring accuracy and appropriateness of billing. 2. Performs administrative support of assigned office duties and provides operational support to ensure departmental efficiency. 2.1 Maintains all files and systems regarding patient charge information and clinic statistics daily as observed by supervisor. 2.2 Screens and/or refers calls taking messages as necessary and reports those messages within the session the call was received or earlier if need be. 2.3 When cross covering the reception desk, schedules all clinic patients ensuring that the designated amount of time is scheduled with the correct dentist/resident. 2.4 Performs clerical tasks that contribute to the need for extra assistance at the reception desk when either patient demand or staffing requires additional support. 3. Provides and supports complex billing functions including reports to the Manager of the Dental Department. 3.1 Assist in the preparation of monthly accounting reports. 3.2 Assists in program audits as required for compliance by the hospital. 3.3 Assist department manager in reviewing, revising and/or creating systems which promote billing efficienies and effectiveness.
Graduation from high school, supplemented by business related courses. Associate''s degree preferred.
Three (3) to (5) years financial/administrative experience including billing claims, the preparation of statistical reports and heavy public contact preferably in a dental office. Must have experience with electronic billing systems, experience with insurance management and collections.
Excellent administrative and organizational skills. Ability to prioritize work assignments. Excellent analytical, communication and interpersonal skills both in person and by telephone. Working knowledge of third party billing and insurance. Must have working knowledge of Eaglesoft software. Working knowledge of dental environment and terminology.
Ensures that patients are greeted courteously and are made to feel comfortable. IIs accountable for the accuracy and timeliness of billing, record keeping and reporting. Ensures completeness and accuracy of all data contained in reports and analyses. Ensures ongoing office and reception support to the Dental Department''s billing function, including monitoring of patients accounts receivable, collections, receipts for services and establishment of payment plans. Maintains work area in a neat and orderly manner.
Works within established departmental guidelines to schedule patient appointments and process billing. Must plan and prioritize work assignments in conformance with established Hospital and departmental schedules and procedures, often under the pressure of deadlines and high patient volume. Deals effectively with patients and their family members in the discussion of sensitive billing issues. Prepares a variety of reports and statistical analyses summarizing billing activity and patient visits.