Job Description

Overview

Smile Brands, a three-time Glassdoor Best Place to Work, is seeking an Insurance Collections Specialist to join our team. We are seeking a detail-oriented individual with experience in claims appeals and reviewing EOBs. The ideal candidate will feel comfortable in a fast-paced environment.

Responsibilities:

• Calling insurance carriers or any other practical research resources to verify if a claim has been received and what the outcome paid and/or denial reason is
  
• Contacting and following up with insurance company representatives
• Updating all patient accounts to correct inaccurate information i.e. demographics, eligibility dates, termination dates and contract allowance and/or maximum
  
• Managing the workflow of assigned accounts and meeting deadlines for filing to obtain maximum reimbursements. Monitoring collections activity for timely payment from all revenue sources
• Understanding and staying informed of changes with procedures, billing guidelines and laws for specific insurance carriers or payers
  
• Following up on any overdue accounts and researching accounts to determine why the balance remains unpaid
• Auditing insurance claims to identify and provide required attachments and auditing attachments for completeness and suitability
• Working zero paid or partial paid Explanation of Benefit (EOB) and take action to appeal or properly adjudicate claims
  
• Ensuring claim submissions for secondary coverage is within timely filing limits
• Ensuring responses to claim inquiries and tracing is within timely filing limits
  
• Conducting full patient account audits to determine appropriate action
• Ensuring all dental billing/collection letters are prepared and mailed according to the set schedule

Responsibilities