Job Title: Claims & Payment Poster

Basic Function:

The primary function of the Insurance Coordinator/Payment Poster is to assist in facilitating all relationships between Hudec Dental and all insurance companies providing payment for services to ensure accurate and timely payment for all services provided, to improve the understanding of how to utilize the benefits available to Hudec Dental’s best interests and otherwise contribute to the continued success and profitability of Hudec Dental.

Essential Duties and Responsibilities:

The following is a list of responsibilities associated with the Insurance Coordinator/Payment Poster but is not exhaustive nor a complete, comprehensive list of the duties required and expected of the Insurance Coordinator; additional duties may be assigned as needed.

Maintains and updates database(s)/spreadsheet(s) by entering new and updated patient claim information.
Verifies status of patient claims with various insurance companies
Tracks and follows up on pending and processed claims for payment
Charges claims out on insurance company portals
Retrieval of Electronic Funds Transfers (EFT) through insurance company portals
Post all Medicaid, DentaQuest, Cigna HMO and CompBenefits EFTs in addition to HMO checks that are cap monthly payments
Post all patient checks and record Mastercard/Visa payments received daily
Request all virtual checks to be changed to paper checks
Request additional documentation from offices
Receive and post all insurance payments; ensure that all adjustments resulting from insurance company receipts are recorded timely, accurately, and consistently.
Review all Explanation of Benefits (EOB) and Denials of Benefits (DOB), determine necessary follow-up action and take such action as required to ensure the maximum allowable receipt by Hudec Dental. Typically, this will require that claims be resubmitted with additional information.
Determine and evaluate trends noticed during the review of EOB’s and DOB’s. Develop action plans on an office specific basis such that all claims are ultimately paid based on the initial development of said action plans to assist the offices in understanding all DOB’s, make applicable corrections in fee schedules to prevent recurrence.
Initiate required adjustments, refunds, and write-offs of accounts, subject to appropriate approval, identified while posting payments.
Audit accounts with unearned credits
Assist offices with claims research and issue resolution
Creating and submitting secondary claims daily
Resolve problems in a timely manner by clarifying issues; research and explore answers and alternative
Open and sort all mail: US Mail and office mail. Update incorrect addresses returned by US Mail.
Assist answering phone calls
Posting patient patient received via mail
Other duties as assigned

Requirements:

Education: Combination of education and experience normally represented by an Associate Degree in a Business-Related Field
Experience: 2-5 years Dental Office experience/knowledge with at least 1 year demonstrated experience as a supervisor or lead
Computer Skills: Clinical software used in the office, Microsoft Office
Language Skills: Ability to respond to patient inquiries, and effectively communicate with insurance companies and others within the organization.
Ability to effectively present information to insurance companies and co-workers

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