Ensure the accurate, timely and complete processing of insurance claims and prior authorizations in compliance with School of Dentistry protocols and procedures.
Essential Duties and Responsibilities:
(1) Manage dental claims through the EDI using Fast Attach for all support documentation. Manage print claims for those commercial companies not participating with EDI. (2) Prepare and submit all necessary prior authorizations for treatment as required by the specific commercial company either electronically or print. Assure all authorizations are re-submitted for extension as necessary. (3) Communicate information regarding prior authorization approval or denial to appropriate providers. (4) Review all dental pending claims at 60 days, rectify any problem, refile or close claim as appropriate. (5) Manage and fulfill all requests from insurance companies for further information within 3 days of receipt. (6) Manage Third party billing for special programs (Adoption Subsidy and Foster Care). (7) Record communication with commercial company representatives related to insurance coverage, prior authorizations, or claims in financial comments in a timely manner. (8) Communicate any registration or other data entry errors to Manager for correction resulting in timely claims processing. (9) Work with Manager to rectify any operational or programming problems resulting in unpaid claims. (10) Perform other related duties as assigned or requested.
High school diploma or equivalent. Associate’s degree preferred.
Minimum 2 years’ experience in medical and dental billing in large dental practice.
3 – 5 years electronic dental claim processing experience in a busy multi provider office including Oral and Maxillofacial surgery.
Experience with medical billing preferred.
Knowledge, Skills and Abilities:
Competent computer skills, experience with an electronic billing system (EDI) and data entry.
Must have a thorough understanding of dental billing codes.
Must have excellent knowledge of CDT codes and diagnosis codes.
Must have thorough knowledge and experience with Medicaid and other third party prior authorization procedures.
Must have excellent verbal and written communication skills.
Must be an analytical thinker with excellent problem solving skills.
Must have the ability to work independently and within a team environment.
Must be able to sit for long periods of time with the ability to use a keyboard.
Must be able to move freely throughout the clinic.
Basic office environment within a busy dental school with multiple dental clinics.
Salary/Pay Information: $13.88 Minimum
Anticipated Schedule: Monday – Friday 8:30 am – 5:00 pm
About University of Detroit Mercy
Michigan’s largest, most comprehensive private university, the University of Detroit Mercy is an independent Catholic institution of higher education sponsored by the Religious Sisters of Mercy and Society of Jesus. The university seeks qualified candidates who will contribute to the University's urban mission, commitment to diversity, and tradition of scholarly excellence. The University of Detroit Mercy is an Equal Opportunity Affirmative Action Employer with a diverse faculty and student body and welcomes persons of all backgrounds.
The University of Detroit Mercy has one goal - to help our students realize their dreams and ambitions. We fulfill that goal by offering challenging academic programs taught by talented, committed professors and supplemented by hands-on research, co-op, and internship opportunities.