Dental Biller

Covenant Community Care, a faith-based charitable non-profit Community Health Center serving the people of Metro Detroit. As a Federally Qualified Health Center, we offer integrated medical, dental and behavioral health care to everyone, regardless of their ability to pay. Covenant is currently looking for a Prior Authorization Coordinator/Dental Biller to work between multiple locations in Detroit.

This position is accountable for the administration and coordination of dental program benefits, including identification of patients who may qualify for discounts and guiding them through the application process. Also processes prior authorizations from initiation to conclusion to ensure timely services are available to patients while following financial and compliance requirements with accuracy and attention to detail.

RESPONSIBILITIES:

• Identifies patients and dental services requiring prior authorization, and obtains authorizations necessary for reimbursement.
• Initiates prior authorization (PA) process entering data online and onto hardcopy forms with appropriate coding and quantities.
• Statuses PA requests with insurance companies and submit appropriate follow-up documentation as needed.
• Coordinates acquisition of supporting documentation from dental staff as requested by insurances for review.
• Responds to incoming calls, faxes, correspondence, and/or email messages pertaining to authorizations.
• Confirms member eligibility by telephone or via online portals before processing authorization requests, during follow-up, and through completion of treatment.
• Ensures all changes in patients’ status are properly documented and discussed with dental staff, billing department, and patients, as needed.
• Maintains correspondence with insurance companies, dental staff, billing department and patients on status of approvals, denials and cash payment options for service.
• Enters treatment plan authorization status into designated module of Electronic Dental Record (EDR).
• Communicates completion of authorized procedures to billing department, signaling readiness for insurance billing.

• Valid driver's license.
• High school diploma.
• Familiarity with eligibility programs such as Medicaid and Medicare, managed health care plans and commercial insurance payers.
• Previous work experience in a dental office, using Electronic Dental Records EDR systems(Dentrix experience preferred), familiarity with both private and public health plans, as well as demonstrated proficiency basic arithmetic functions.
• Experience with coding, sliding fee discounts, and healthcare billing is a plus.
• Strong organization skills and ability to prioritize work.

Travel

• Required