Dental Billing Specialist

Smilebuilderz LLC; Lancaster (Lancaster County); On-site; USD 42,000 - 62,000; Full time

Job summary

Smile builderz is a well‑established private dental practice in Lancaster County, PA, seeking a Billing Specialist to verify insurance coverage for proposed treatments and provide patients with benefit estimates. The role includes preparing predetermination requests and communicating insurance details with patients.

Key duties include submitting claims within 72 hours, accurate dental coding with documentation, monitoring claim status, assisting in appeals, and maintaining organized records

Qualifications

• High school diploma or equivalent.
• Previous experience in dental billing, insurance verification, or related roles is preferred.
• Strong attention to detail and excellent organizational skills.
• Strong communication and customer service skills.

Responsibilities

• Verify insurance coverage and eligibility for proposed dental treatments before submitting claims.
• Create, batch, and send dental claims to insurers within 72 hours of service date.
• Code procedures accurately with proper documentation and notes attached to claims.
• Assist with predetermination requests to insurance companies.
• Monitor claim status and follow up to ensure timely responses.
• Address claim issues with insurers promptly.
• Coordinate interoffice requests and discrepancies for the Sending team.
• Maintain organized records of claims, responses, and patient communications.
• Assist in appeals if claims are denied or discrepancies occur.
• Stay updated on insurance regulations and ensure compliance in the claims process.

Skills

Attention to detail

Organizational skills

Communication skills

Customer service

Education

High school diploma or equivalent

Job description

Description

Smile builderz is a well‑established private multi‑specialty dental practice located in Lancaster County, PA. We are looking for a billing specialist to join our team. This position involves verifying insurance coverage for proposed dental treatments, preparing, and submitting predetermination requests, and communicating with patients to provide estimates of insurance benefits.

Job Responsibilities

1. Verify patients’ insurance coverage and eligibility for proposed dental treatments before submitting claims.
2. Accurately create, batch, and send dental claims to insurance companies within 72 hours of the patient’s date of service.
3. Input accurate dental coding of procedures, with correct documentation, images and notes attached with the insurance claims.
4. Assist with monitoring predetermination requests to insurance companies.
5. Monitor the status of claims and follow up with insurance companies to ensure timely responses.
6. Address claim issues with insurance companies within a timely manner.
7. Monitor and address interoffice requests and discrepancies for the Sending team.
8. Maintain accurate records of claims requests, responses, and patient communications. Ensure documentation is organized and readily accessible.
9. Assist in the appeals process if claims are denied or if there are discrepancies.
10. Stay informed about insurance regulations and ensure that the practice complies with insurance guidelines in the claims process.

Requirements

• High school diploma or equivalent.
• Previous experience in dental billing, insurance verification, or related roles is preferred.
• Strong attention to detail and excellent organizational skills.
• Strong communication and customer service skills.