Dental Coder and Billing Specialist

JOB SUMMARY The Dental Coding Specialist is responsible for accurately reviewing, assigning, and validating dental procedure codes (CDT codes) for patient services to ensure proper billing, insurance claim submission, and regulatory compliance. This role works closely with dental providers, billing teams, and insurance companies to maximize reimbursement and maintain accurate patient records.

• Review dental records and documentation for coding accuracy with high attention to detail
• Assign appropriate CDT and related codes for dental procedures and diagnoses.
• Audit and submit insurance dental claims.
• Resolve claim denials, coding discrepancies, and reimbursement issues.
• Ensure compliance with dental coding guidelines, payer rules and regulations.
• Maintain accurate patient billing and coding records.
• Communicate with providers, staff, and insurance carriers regarding coding questions.
• Stay current on coding updates, regulations, and industry best practices.

Effectively and respectably communicate with other individuals, whether it be a colleague, patient, or patient’s family member and appropriately enumerate information in a manner easily understood by all parties. We do this to foster a culture of understanding between all parties, especially in complex and difficult situations, to ultimately provide the best care possible to our patients and their families.

Ability to make the most appropriate decision in a given situation and then taking the next steps to ensure appropriate and timely completion. This requires conflict resolution skills, critical thinking skills, confidence in your ability to make the right decision in most situations. This also includes ability to prioritize your workday appropriately to ensure the most important tasks are completed on time.

Having the drive to keep yourself abreast and up to date on the new breakthroughs in your area of expertise and communicating them to the rest of the team, as appropriate. This also includes keeping up with your licensure and yearly training requirements within your area expertise along with MAHEC's organizational training. Finally, the ability to apply the depth of knowledge maintained and gained through this process in real life scenarios as appropriate.

Showing the ability to meet difficult situations with grace, professionalism, and understanding. Within your area of expertise, showing respect and showing empathy where appropriate with your colleagues, patients, and their family at all times, even when its most difficult to do so. This is done, in part, by effective listening, being your authentic self, showing responsibility and dependability, and being patient with others.

Adherence to MAHEC's founding principles and incorporating them every day. This includes, among others, having integrity and accountability, reverence for other cultures and equitable practices, ability to manage change, and displaying a clear understanding of organizational dynamics. Doing these things creates a culture where people want to do the best for each other and gives personal ownership towards the goal of helping people in their time of need.

Having an analytical mind and ability to work autonomously to solve complex problems that may arise. The wherewithal to think logically through a difficult problem and come to an appropriate resolution for a given issue. This helps to drive continuous improvement by thinking through where we can improve in a novel way. Measures success by understanding where we are currently and where we want to go and then applying those new ideas to affect positive change.

REQUIRED:

Certified Dental Billing Specialist (CDBS) or Certified Dental Coder (CDC) Knowledge of dental terminology, CDT codes, ICD-10, and dental insurance billing. Ability to successfully navigate insurance carrier websites to enter and upload benefit breakdowns into dental software systems.

Excellent skills in Microsoft Office including Word, Excel, PowerPoint, and database applications required. Proficiency with dental practice management and electronics health record systems.

FOREIGN LANGUAGE Spanish speaking skills preferred.

Not applicable.

Not applicable.

High School Diploma or GED equivalent required Minimum of 2 years' experience in: dental coding and insurance interpreting clinical and diagnostic records navigating insurance carrier websites and uploading insurance benefit breakdowns into dental software systems.

Regular attendance on-site is an essential function of this position; includes some remote work and flexible work schedule. Typical business hours are Monday - Friday, 8:00 am to 5:00 pm (or flexed to best meet the needs of the organization), 40 hours per workweek;…