North American Dental Group (NADG)

Accounts Receivable

• Processing dental claims for payment by insurance companies to ensure appropriate and timely coding, billing and collections
• Performs manual and electronic posting functions for all payors/patient accounts, including cash balancing and reconciliation of bank deposits
• Post payment corrections, payment transfers and NSF’s
• Research and clear unapplied accounts using established identification functions/process
• Maintains knowledge of insurance rejections/denial processing and appropriately posts information for collection and follow up activity
• Responsible for all aspects of follow up and collections, including making phone calls and accessing payer websites
• Identify issues or trending and provide suggestions for resolution
• Accurately and thoroughly documents pertinent collection activity performed
• Review account information and necessary system applications to determine the next appropriate work activity
• Reviews, investigates and resolves claims that have been rejected or denied by insurance
• Verify claims adjudication utilizing appropriate resources and applications
• Perform appropriate billing functions, including manual re-bills and electronic submission to payers
• Edit claims to meet and satisfy billing compliance guidelines for electronic claim submission
• Initiates appeals and ensures all required documentation is submitted in the appeal process
• Answers patient billing questions and acts as a resource for patient billing questions
• Maintains ledger accuracy and account integrity
• Analyzes and corrects insurance accounts receivable and payment posting ledger and posting errors
• Researches payor recoupments, identifies errors or opportunities to dispute and restore lost revenue
• Researches and validates patient refunds
• Verifies insurance benefits utilizing websites, fax and phone
• Reviews patient accounts to determine and correct discrepancies, including account audits, aging AR, unapplied adjustments, resolving credit balances and unposted payments
• Researches and follows up on correspondence associated with assigned accounts
• Performs other duties and responsibilities as assigned by leadership

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Accounts Receivable Specialist