Billing Specialist

Brown-University-Health-1; Providence (RI); On-site; USD 30,000 - 50,000; Full time

Job summary

Brown University Health is seeking a dental coder to assign CDT codes for patient encounters under supervision. You will review dental records, reference coding manuals, and ensure compliance with AHIMA and CMS guidelines while collaborating with clinicians and billing staff.

Responsibilities include accurate data entry in the Dentrix system, conducting regular audits, and resolving denials with Patient Financial Services. Strong CDT coding knowledge and customer service are essential.

Qualifications

• High School Diploma or equivalent; CDT coding training.
• Experience with dental software, preferably Dentrix.
• Strong PC skills and courteous customer service.
• Interpersonal skills for professional communication.

Responsibilities

• Review dental records to assign diagnosis and procedure codes.
• Reference coding manuals to ensure accurate billing codes.
• Apply sequencing guidelines per AHIMA/CMS/ADA directives.
• Contact dentists to clarify missing information.
• Enter coding data into the Dentrix system and billings.
• Audit documentation for compliance and resolve denials.
• Collaborate with staff on coding and billing questions.

Skills

CDT coding

Anatomy & physiology

Dental terminology

Dentrix

Customer service

PC skills

Education

High School Diploma or equivalent

Tools

Dentrix

Job description

SUMMARY:Under the general supervision of the Administrative Coordinator and Practice Manager, and according to established guidelines, ensures accurate assignment of diagnostic, service and procedures coding of dental patient encounters. These duties include qualitatively analyzing dental patients’ dental record to assign CDT codes within the parameters of the Brown University Health’s standards. Functions as a coding/billing resource to department staff. Researches and reconciles coding errors or omissions.Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another.In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:Instill Trust and Value DifferencesPatient and Community Focus and Collaborate

RESPONSIBILITIES

• Reviews dental record documents and patient encounter forms for dental patients to identify and assign appropriate diagnosis and procedure codes.
• References appropriate coding manuals to ensure accurate assignment of billing codes.
• Applies sequencing guidelines to coded data according to established coding protocols and in compliance with the American Health Information Management Association (AHIMA’s) Code of Ethics and considering directives from Centers for Medicare and Medicaid Services (CMS), in compliance with the American Dental Association (ADA).
• Contact dentists and other health care professionals to obtain or clarify missing or ambiguous information contained within the record.
• Enters coding/billing information into the Dentrix computerized billing system.
• As necessary, creates paper invoices.
• Reviews related revenue reports regularly to reconcile charges on patient ledgers against the reported data.
• Researches and reconciles missing charges and/or corrections into the billing system.
• Interacts with patients and Patient Financial Services in order to resolve billing issues, including denials.
• Performs regular audits to identify completeness and accuracy of documentation and to promote and maintain compliance with payor reimbursement policies and governmental regulations (including Medicare/CMS Guidelines).
• May review electronic dental records to assess the adequacy of documentation to ensure appropriate support for the principal diagnoses, principal procedure, complications, co-morbid conditions, secondary diagnoses and procedures to facilitate the accuracy and completeness of coding activities.
• Reports inconsistencies in documentation to the Administrative Coordinator.
• Functions as resource to others within the department, including coding and professional staff for questions related to coding and billing activities.
• Maintains knowledge of outpatient compliance and reimbursement policies and practices, including medical necessity and coding issues.
• Refers more complex questions or issues to the Administrative Coordinator.

SUPERVISORY RESPONSIBILITY

None.

MINIMUM QUALIFICATIONS

BASIC KNOWLEDGE

• High School Diploma or equivalent. Training in CDT coding, anatomy, physiology, and dental terminology.
• Experience with Dental software, preferably Dentrix.
• Demonstrated knowledge of PC skills using the windows operating system environment and accompanying software packages. Must have knowledge of medical/dental billing routines for physician office practice. Must use and have knowledge of courteous telephone technique and good customer service skills.
• The interpersonal skills to exchange factual information with patients and outside agencies with cultural sensitivity and professionalism.

EXPERIENCE

• Two years’ related experience coding and billing using dental billing software and demonstrated expertise and accuracy of code assignment.

Pay Range:

$22.04-$36.37

EEO Statement:

Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

Location:

Rhode Island Hospital - 593 Eddy Street Providence, Rhode Island 02903

Work Type:

M,T,Th,F 8:00am-4:30pm

Work Shift:

Day

Daily Hours:

8 hours

Driving Required:

No