[New Job Vacancy] Dental Medical Billing Specialist job in St Croix Chippewa Indians of Wisconsin – Tribal Government, (Webster, WI 54893) – Jobs in Webster, WI 54893

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Job Opening details:-
Company Name :-
St Croix Chippewa Indians of Wisconsin – Tribal Government
Position Name :-
Dental Medical Billing Specialist
Company Location :-
Webster, WI 54893
Job Category :
 Back office jobs

Full Job Description :-
Position Title: Dental, Medical Billing Specialist
Facility: St. Croix Tribal Health Clinic
Job Family: Health and Human Services
Comp Grade: Negotiable (K-1) Status: FT
St. Croix Chippewa Indians of Wisconsin Leadership will strive to uphold the mission, vision, and values of the organization. They will serve as role models for staff and act in a people centered, service excellence-focused and results oriented manner.
Position Summary:
This position reports to the Business Office Manager and is responsible for the preparation and submission of all billing claims for Dental and Medical services. Claims are continuously filed to Medicare, Medicaid and Private insurances. This position is responsible for implementing policies, procedures and systems for quality assurance as well as training and educating new and existing employees on credentialing and expectations for billing purposes.
Essential Functions:
· Dental and Medical Billing
· Responsible for coding Dental bills
· Tracking and following-up with insurance claims
· Working with Dental staff and operations team on how to resolve issues and answer questions
· Support workflow development for our dental office to ensure accurate and consistent processing
Dental Medical Billing Specialist Job Duties:
· Maintain knowledge of current ADA, CPT, HCPCS, modifiers and ICD-10 Coding, Medicare policies and HCFA requirements
· Working with Dentrix Software and RPMS Medical software
· Check eligibility and benefits verification for treatments and procedures
· Review patient bills for accuracy and completeness, and obtaining any missing information
· Prepare, review, and transmit claims using billing software, including electronic and paper claim processing
· Responsible for submitting medical claims to insurance companies and payers such as Medicare, Medicaid and Commercial Insurances
· Process claims, on a timely basis, for Private Insurance, Medicare, Medicaid, and other third party insurances. Create billable claims, approving claims for submission to insurances.
· Provide clear and concise communication with patient, provider and business office on missing or inaccurate insurance information to resolve issues in a timely manner for optimal payment on claims
· Follow up on unpaid and denied claims within standard billing cycle timeframe
· Check each insurance payment for accuracy and compliance with contract discount
· Call insurance companies regarding any discrepancy in payments if necessary
· Identify and bill secondary or tertiary insurances
· Review accounts for insurance or patient follow-up
· Answering all patient or insurance telephone inquiries pertaining to claims
· Maintains Dental, PNCC and Community Health billing fee schedule
· Provides education and guidance to team members for proper Revenue Cycle Procedures
· Obtain and maintain provider certifications with various billing agencies such as Medicare and Medicaid. Prepare facility provider application forms and maintain the provider application forms and licenses on file
· Prepare and submits application to new insurers along with Business Office Manager and prepares/submits reports to management upon request
· Ensure adherence to objectives, operating policies and procedures and strategic action plans for achieving goals of team and agency
· Maintain patient confidentiality in accordance with the Federal Privacy Act and HIPAA
· Attend meetings and workshops pertinent to successful billing practices with third party carriers
· Back-up for Medical Billing Specialist
· Any other duties assigned by supervisor
Note: The essential functions are intended to describe the general contents of and requirements of this position and are not intended to an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbent’s immediate manager.
Type of Supervisory Responsibilities: N/A
Supervisory Responsibilities: N/A
Directly Reporting to: Business Office Manager
Matrix of INDIRECT Reporting: St. Croix Tribal Council
Scope and Complexity:
Interacts with all levels of management and employees; often trusted with maintaining confidentiality and relaying highly sensitive messages, and appropriate application of business operations and practices.
Physical Demands/Environment Factors:

Requires extensive sitting with periodic standing and walking.
May be required to lift up to 50 pounds.
Requires significant use of personal computer, phone and general office equipment.
Needs adequate visual acuity, ability to grasp and handle objects.
Need ability to communicate effectively through reading, writing, and speaking in person or on the telephone.
May require off-site travel.

Minimum Qualifications

High School Diploma
A minimum of 2 years of dental and health care billing experience
Dental coding experience
Familiarity with current ADA, CPT, HCPCS, modifiers and ICD-10 Coding, Medicare policies and HCFA requirements
Knowledge of the accounts receivable process in accordance with billing
Knowledge of Federal and State laws and requirements relating to healthcare management and HIPAA
Knowledge of Dental & Medical Terminology
Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid and other payer requirements and systems
Experience with RPMS system and related duties within the program for billing verification, posting, aging and adjustments preferred
Competent use of computer systems, software, and 10 key calculators
Proficiency with Microsoft Suite of office programs
An effective communicator with strong oral, written and persuasive skills and capability to collaborate with people at all levels internal and external to organization
Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds
Problem-solving skills to research and resolve discrepancies, denials, appeals, collections
Ability to work independently and as part of a team
Ability to multitask

Preferred Qualifications:
· Dental Coding Certification
· Experience with a Native American Tribal organization and/or not-for-profit agency desirable
· Experience working with Native American communities
Requirement of Employment: Mandated COVID Vaccination Required.
Native American Preference Given in Accordance with P.L. 93-638 and Amendments
For a complete job description or a listing of other vacancies
visit our website: stcroixojibwe-nsn.gov
Inquiry: Jackie Mallory, HR Manager24663 Angeline Avenue Webster, WI 54893(715) 349-2195 x 5413 Fax (715) 349-7811
Please contact above individual for application
and additional information regarding openings.
Job Type: Full-time
Pay: From $17.92 per hour
Benefits:

401(k)
401(k) matching
Dental insurance
Disability insurance
Employee discount
Flexible schedule
Flexible spending account
Health insurance
Life insurance
Paid time off
Vision insurance

Schedule:

8 hour shift
Monday to Friday

COVID-19 considerations:All personnel receive screenings when reporting in-person and self monitoring for symptoms while working. Limited access to our facilities by outside individuals – access granted with prior arrangements.
Education:

High school or equivalent (Preferred)

Experience:

relevant: 2 years (Preferred)

Work Location: One location

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