Billing Specialist

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

Job summary

Rhode Island Hospital is seeking a dental coder to assign CDT codes for dental encounters under supervision and to analyze patient records for accurate coding. This role supports billing accuracy and serves as a resource for staff on coding and billing practices.

Responsibilities include consulting manuals, coordinating with dentists, entering data into Dentrix, auditing charges, and resolving billing issues while adhering to AHIMA, CMS and ADA guidelines.

Qualifications

• High School Diploma or equivalent.
• Training in CDT coding, anatomy, physiology, and dental terminology.
• Experience with Dental software, preferably Dentrix.
• Knowledge of PC skills in Windows and dental billing routines.
• Courteous telephone technique and good customer service skills.
• Interpersonal skills to interact with patients and outside agencies.

Responsibilities

• Review dental record documents and patient encounter forms to identify and assign diagnosis and procedure codes.
• Reference coding manuals to ensure accurate billing codes.
• Apply sequencing guidelines per AHIMA, CMS and ADA directives.
• Contact dentists and other health care professionals to obtain missing or ambiguous information.
• Enter coding/billing information into the Dentrix system.
• Create paper invoices as needed.
• Review revenue reports to reconcile charges on patient ledgers.
• Research missing charges and corrections in the billing system.
• Interact with patients and Patient Financial Services to resolve billing issues.
• Perform regular audits to ensure documentation completeness and compliance.
• Report inconsistencies to the Administrative Coordinator.
• Serve as a resource to staff for coding and billing questions.
• Maintain knowledge of outpatient compliance and reimbursement policies.

Skills

customer service

communication

interpersonal skills

courteous telephone technique

Education

High School Diploma or equivalent

Tools

Dentrix software

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.

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

• 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