Minimum Qualifications

The Dental Biller must possess a high school diploma or GED and a minimum of two (2) years of experience in dental billing, preferably in a Federally Qualified Health Center (FQHC) or comparable healthcare setting.

Proficiency in Dentrix dental practice-management software is required. The employee must demonstrate knowledge of dental procedure coding using Current Dental Terminology (CDT), dental insurance claims processing, and applicable Medicaid, Medicare, and commercial payer requirements.

The employee must meet the competencies and performance standards established by EXCELth, Inc., and demonstrate the ability to maintain accurate records, protect confidential information, and perform assigned duties within established organizational policies and procedures.

General Description
The Dental Biller is responsible for the accurate, timely, and compliant processing of dental claims and related revenue cycle activities for EXCELth, Inc.

This position supports dental reimbursement operations through claim review and submission, insurance verification, payment posting, denial resolution, account follow-up, and billing reconciliation activities.

The Dental Biller works collaboratively with dental providers, front office personnel, the Dental Director, and the Revenue Cycle team to support accurate documentation, appropriate reimbursement, and efficient resolution of billing issues.

The employee is expected to demonstrate professionalism, attention to detail, confidentiality, accountability, and a commitment to patient-centered service.

Required Skills and Competencies

Proficiency in Dentrix dental practice-management software.

Knowledge of Current Dental Terminology (CDT) coding and dental billing procedures.

Knowledge of Medicaid, Medicare, and commercial dental insurance billing requirements.

Insurance eligibility and benefit verification.

Dental claims preparation, submission, correction, and follow-up.

Denial management and accounts receivable follow-up.

Payment posting, account reconciliation, and adjustment procedures.

Familiarity with electronic health records and clinical documentation systems.

Knowledge of HIPAA privacy and security requirements applicable to assigned duties.

Accuracy in data entry, recordkeeping, and financial documentation.

Strong analytical, problem-solving, organizational, and time-management skills.

Effective communication, customer service, and teamwork.

Ability to manage competing priorities and meet established deadlines.

Duties and Responsibilities

Dental Claims and Billing Operations

Review dental encounters and related documentation for billing completeness and accuracy.

Prepare, submit, and track dental insurance claims using Dentrix and other approved systems.

Verify that claims contain appropriate CDT procedure codes and required supporting information.

Identify incomplete, inconsistent, or missing documentation and refer discrepancies to the appropriate provider or authorized staff for correction.

Review rejected, unpaid, and denied claims; investigate discrepancies; and complete timely follow-up or resubmission.

Communicate with insurance carriers regarding claim status, payment issues, coverage questions, and required documentation.

Monitor assigned accounts receivable and follow up on outstanding claims according to established revenue cycle procedures.

Maintain awareness of applicable payer requirements, billing changes, and filing deadlines.

Payment Posting and Account Accuracy

Post insurance payments, patient payments, contractual adjustments, and other authorized transactions accurately in Dentrix.

Review payment information and identify discrepancies between expected and actual reimbursement.

Assist with reconciliation of billing records and payment reports in accordance with approved financial controls.

Refer refunds, write-offs, disputed adjustments, and other transactions requiring authorization to the appropriate supervisor or designated department.

Generate and review billing, collections, denial, and accounts receivable reports as assigned.

Insurance Verification and Patient Account Support

Verify dental insurance eligibility, coverage, and benefits as assigned, coordinating with front office staff to prevent duplication of work.

Identify prior authorization or documentation requirements and coordinate follow-up with the appropriate staff.

Respond professionally to patient billing questions and explain account balances, charges, and insurance processing information within the scope of the position.

Refer clinical questions, financial assistance determinations, and other matters outside the employee's authority to the appropriate staff.

Documentation, Compliance, and Collaboration

Work with dental providers and clinical personnel to resolve billing-related documentation questions without independently altering clinical records.

Maintain accurate and complete billing records in approved systems.

Protect patient health information and financial information in accordance with HIPAA and EXCELth policies.

Assist with internal billing reviews, audits, corrective action activities, and quality improvement initiatives.

Communicate recurring billing issues, denial patterns, and workflow concerns to the appropriate supervisor.

Participate in required training and maintain knowledge of current billing practices and applicable requirements.

Collaborate with the Dental Director, Revenue Cycle team, Finance, and front office staff to support effective dental billing operations.

General Organizational Responsibilities

Follow EXCELth policies and procedures and support the organization's mission and vision.

Participate in required safety training, drills, and incident reporting procedures.

Travel to other EXCELth locations when required for assigned job responsibilities.

Perform other related duties consistent with the position, employee qualifications, and organizational needs.

Reporting Relationship

Direct Supervisor: Revenue Cycle Manager

The Dental Biller collaborates with the Dental Director and Revenue Cycle Manager regarding dental documentation, billing performance, and revenue cycle operations. Final supervisory and performance evaluation responsibilities will follow EXCELth 's approved organizational structure.

Additional Position Requirements

The employee must be able to maintain confidentiality, use assigned computer systems accurately, communicate professionally with patients and colleagues, and perform the essential functions of the position with or without reasonable accommodation.

Benefits
EXCELth, Inc. offers eligible employees a benefits package that may include:
- Medical, dental, and vision insurance
- Life and disability insurance
- Retirement benefits
- Accrued annual leave and other applicable paid time off
- Employee Assistance Program (EAP)
- Tuition reimbursement, where available
Benefit eligibility, employer contributions, and coverage are subject to the applicable plan documents and EXCELth policies.