Medical Billing Claim Specialist

Summary

Join our medical billing team as a focused and experienced Preauthorization and Claim Follow-Up Specialist for dentistry. This role ensures successful integration of dental procedures into medical billing by managing pre-authorizations and monitoring claim progress. You will track preauthorization statuses, communicate outcomes, follow up with insurance carriers on claim processing, identify claim delays, and document all correspondence. The ideal candidate possesses a solid understanding of medical claims and pre-authorization processes. This position offers opportunities for career growth and learning, along with work-from-home flexibility.

Requirements

• 2+ years of experience in medical billing, preferably with dental-medical
• Working knowledge of dentistry
• Familiarity with pre-authorization requirements across commercial and government payers
• Experience using medical billing software and payer portals
• Excellent communication and follow-up skills
• Strong attention to detail and accuracy
• Ability to prioritize multiple tasks in a fast-paced setting
• Self-motivated with strong organizational skills

Responsibilities

• Track preauthorization statuses and update internal systems to reflect approval timelines and limitations
• Communicate preauthorization outcomes and requirements to the PPO Profits medical billing leads
• Initiate timely follow-up with insurance carriers to confirm claim processing, payment, or the need for additional documentation
• Identify common claim delays and collaborate with internal teams to correct and prevent future issues
• Document all correspondence and status updates clearly and accurately in the billing system

Preferred Qualifications

• Certification in billing/coding
• Experience with conversing with insurance companies for details
• Prior dental office or dental billing service experience

Benefits

• HMO with 1 free dependent upon hire (with Dental coverage)
• Life Insurance
• 20% Night Differential
• 20 PTO credits annually
• Great Company Culture
• Career Growth and Learning
• Work from home