Billing Specialist

RIH Rhode Island Hospital; Rhode Island; On-site; USD 30,000 - 50,000; Full time

Job summary

Brown University Health is seeking a dental coder to ensure accurate assignment of CDT codes for patient encounters. You will review records, reference coding manuals, and ensure compliance with AHIMA and CMS guidelines, while serving as a billing resource for the department.

The role emphasizes data integrity, patient communication, and collaboration with staff to resolve denials and missing charges in a busy dental practice.

Qualifications

• High School Diploma or equivalent.
• Training in CDT coding, anatomy, physiology, and dental terminology.
• Experience with Dental software, preferably Dentrix.
• Knowledge of medical/dental billing routines for physician office practice.
• Courteous telephone technique and good customer service skills.
• Interpersonal skills for communicating with patients and outside agencies.

Responsibilities

• Reviews dental records and encounter forms to identify and assign diagnosis and procedure codes.
• References coding manuals to ensure accurate billing codes.
• Applies sequencing guidelines per AHIMA CMS and ADA directives.
• Contacts dentists to obtain missing or clarified information.
• Enters coding/billing data into the Dentrix system and creates paper invoices as needed.
• Reviews revenue reports and reconciles charges on patient ledgers.

Skills

Customer service

Dental terminology

Education

High School Diploma or equivalent

CDT coding training

Tools

Dentrix

Dental software

Job description

SUMMARY

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 Differences Patient 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.

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.

SUPERVISORY RESPONSIBILITY:None.

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

As Rhode Island's largest health system and private employer, Brown University Health is the state’s premier provider of health services and includes the only Level I Trauma Center for southeastern New England. Today, more than 20,000 people work at Brown University Health and bring their unique skills, experiences, and compassion to their jobs every day. Formed in 1994, Brown University Health is a not-for-profit health system based in Providence, RI comprising three teaching hospitals of The Warren Alpert Medical School of Brown University: Rhode Island Hospital and its Hasbro Children's; The Miriam Hospital; and Bradley Hospital, the nation’s first psychiatric hospital for children; Newport Hospital, Saint Anne's Hospital and Morton Hospital, community hospitals offering a broad range of health services; Gateway Healthcare, the state’s largest provider of community behavioral health care; and Brown Health Medical Group, the largest multi-specialty practice in Rhode Island. Brown University Health is an equal opportunity employer that values diversity of cultural background, race, gender, age, religion, identity, ability, and perspectives - we are actively committed to a diverse workforce that represents the patients and community that we serve. We are invested in creating a respectful, inclusive, and equitable environment that supports the holistic well-being of our employees and their families. Join us and help build a healthier future for our patients - and for yourself.

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