Overview
Tufts University School of Dental Medicine (TUSDM) offers one of the most forward-looking educational environments in dental medicine in the country. The Medical and Dental Billing team (Clinic Billing Operations), along with other members of the Finance and Administration team, support the financial management and administration of the dental school. This position reports directly to the Billing Manager and works closely with the School Clinic it supports: Postgraduate Prosthodontics Clinic.
Clinic Billing Operations (CBO) remotely supports all patient care services billing for the Predoctoral, Postgraduate and Specialty clinical treatment areas of the School, as well as any needed billing support for IRB clinical study patients and maintaining CITI certification. The Postgraduate Clinics (residents) are the Specialty Clinics, which includes: Endodontics, Orthodontics, Periodontics, Prosthodontics, Pedodontics and Oral and Maxillofacial Surgery. CBO also supports Dental Faculty Practice, Craniofacial Pain and Sleep Center, Oral Medicine, Oral and Maxillofacial Pathology, AEGD, Geriatric Dentistry and Tufts Dental Facilities.
What You'll Do
Under limited supervision, the Billing Lead serves as the first-line resource for billing teammates, residents, students and internal teams, by providing relevant and timely feedback to expedite and support timely and accurate claims submission. Clinic Billing Operation’s Billing Lead oversees all billing processes, including recommending solutions to billing processes and handling complicated patient billing issues and complex account reconciliation; consistently seeks to improve day-to-day billing processes and procedures; ensures that the team is up to date on any/all insurance billing guidelines and appeals procedures; ensures timely claims submission, appeals and follows up to collections. This Billing Lead's role and responsibilities are deadline driven, requiring accuracy; proven complex account reconciliation and exceptional attention to detail, while managing/distributing billing teammates’ workload and ensuring accounts are within the set aging percentage perimeters and monitors aged accounts, ensuring metrics are met or exceeded; reviews denied claims for trends or issues that lead to rejections or payment delays.
This individual’s work fully encompasses Billing Assistants (I & II) and Billing Coordinators’ roles and responsibilities, such as, submitting dental/medical claims and following up with insurance companies; reviewing claims and charges for accuracy, resubmitting and/or appeals denied claims; posts payments/adjustments to patient accounts, answering complex patient claims/billing inquiries and works aged patient accounts. The Billing Lead plays a vital role in the Dental School’s revenue cycle and has a direct impact on the PG PROS clinic’s financial and billing outcomes success. Performs other billing related duties, to assist in revenue cycle management.
What We're Looking For
Basic Requirements:
- Bachelor’s Degree/Associate’s Degree preferred and 2+ years of experience in dental billing or financial coordination with advanced dental/medical healthcare knowledge and expert knowledge of axiUm software.
- Needs to be driven, Excel knowledge, innovative, independent, self-starter, a leader, team player, analytical intelligence, exceptional attention to detail, healthcare business or insurance knowledge, ability to effectively communicate technical information, aptitude and willingness to learn and drive change.
- Dental coder certification (CDC) required.
Preferred Qualifications:
- Bachelor’s Degree preferred.
- Certified Dental Coder (CDC) applicant with 4 - 6 years of medical/dental billing or financial coordination.
- Knowledge of third-party billing.
- Excel expert.
- Knowledge of MassHealth and Medicare regulations and guidelines, as well as commercial dental/medical insurance coding/billing practices.
- Familiarity with ADA codes, CPT Codes and ICD-10 Codes.
- Experience in a fast-paced dental/medical setting.
