Accounts Receivable Specialist

Summary

D4C Dental Brands is seeking an Accounts Receivable Specialist to support dental insurance billing and reimbursement operations. The role reviews and resolves insurance claims, manages appeals and recoupments, audits patient ledgers, and collaborates with dental staff and cross-functional teams to ensure accurate billing and maximize reimbursement.

Responsibilities

• Review and work aging and outstanding claim reports with accuracy and efficiency
• Verify the status of insurance claims and proactively follow up on discrepancies or delays
• Maintain detailed, accurate, and up-to-date documentation within the billing system
• Prepare, submit, and manage insurance appeals as needed
• Audit patient ledgers to ensure accuracy and identify discrepancies
• Initiate and manage insurance recoupments
• Submit and process secondary insurance claims
• Investigate and resolve claim denials, rejections, underpayments, and overpayments
• Submit corrected claims and complete necessary claim adjustments
• Analyze denial patterns and report trends to leadership for process improvement
• Ensure all claims are thoroughly worked to maximize reimbursement
• Coordinate with insurance carriers to resolve complex claim issues
• Collaborate with dental staff and cross-functional departments to ensure accurate billing and resolve discrepancies

Skills

• Strong knowledge of dental insurance billing and accounts receivable processes
• Knowledge of EOBs and ERAs, including insurance payments, adjustments, write-offs, deductibles, and patient responsibility
• Understanding of CDT codes, dental procedures, and insurance terminology
• Knowledge of claim submission, rejection, denial, correction, resubmission, and appeals
• Understanding of PPO fee schedules, contractual adjustments, downgrades, frequency limitations, missing-tooth clauses, coordination of benefits, and timely filing requirements
• Knowledge of AR aging, including 30-, 60-, 90-, and 120+ day outstanding balances
• Familiarity with dental practice-management systems along with payer portals and clearinghouses

Qualifications

Must Haves

• Strong knowledge of dental insurance billing and accounts receivable processes
• Knowledge of EOBs and ERAs, including insurance payments, adjustments, write-offs, deductibles, and patient responsibility
• Understanding of CDT codes, dental procedures, and insurance terminology
• Knowledge of claim submission, rejection, denial, correction, resubmission, and appeals
• Understanding of PPO fee schedules, contractual adjustments, downgrades, frequency limitations, missing-tooth clauses, coordination of benefits, and timely filing requirements
• Knowledge of AR aging, including 30-, 60-, 90-, and 120+ day outstanding balances
• Familiarity with dental practice-management systems along with payer portals and clearinghouses

Benefits

• Paid Time Off
• Paid Holidays
• Medical, Dental and Vision benefits
• Health Savings Account, Flex Spending
• 401K
• Short and Long Term Disability Insurance
• Life Insurance
• Opportunities for Community Service
• Remote position