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Insurance Collections Specialist - Full-Time In Houston, TX

Southern Dental Associates

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Overview

Smile Brands, a Glassdoor Top 25 Best Place to Work, is seeking an Insurance Collections Specialist to join our team at Southern Dental Associates Heights in Houston, TX.

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

  • 1 year of experience in a similar role or reviewing claims and appeals
  • A G3 attitude – Greeting, Guiding & Gratitude – in verbal and written communications with internal and external clients

Smile Brands Inc. and all relevant Affiliates are Equal Opportunity Employers. We are proud to celebrate diversity and provide an inclusive workplace for all employees.



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