Fair Haven Community Health Care

FHCHC is a forward-thinking, dynamic, and exciting community health center that provides care for multiple generations at nearly 130,000 office visits in 17 locations. Overseen by a Board of Directors, the majority of whom are patients themselves, we are proud to offer a wide range of primary and specialty care services, as well as evidence-based patient programs to educate patients in healthy lifestyle choices. As we grow and are able to bring high-quality health care to more areas that need access, we continue to put our patients first in everything we do. The mission of FHCHC is “To improve the health and social well-being of the communities we serve through equitable, high quality, patient-centered care that is culturally responsive.”

For over 50 years, we have been a health care leader in our community focused on providing excellent, affordable primary care to all patients, regardless of insurance status or ability to pay. Fair Haven is proud to have a diverse and motivated team of professionals who are constantly seeking ways to enhance and improve the health and well-being of all patients. We believe that everyone should have access to high-quality medical and dental care, regardless of ability to pay.

Job purpose

Fair Haven prides itself on efficient billing services including the filing of claims, appeals processing, authorizations and, above all, a great passion for helping individuals obtain treatment. The Billing Specialist/Dental Authorization Coordinator works with the Billing and Dental department verifying benefits for patients and ensuring benefits quoted are accurate and detailed.

Duties and responsibilities

The Billing Specialist/ Dental Authorization Coordinator maintains the professional reimbursement and collections process for the dental program. Typical duties include but are not limited to:

Billing

• Performs billing and computer functions, including data entry, documentation review and encounter posting
• Prepares and submits clean claims to various insurance companies either electronically or by paper when necessary
• Work claims and claim denials to ensure maximum reimbursement for services provided

Carrier Authorizations

• Verifying patients' insurance and obtaining coverage breakdowns
  • Creating ABNs as needed based on coverage
• Schedule/treatment plan reviews for carrier authorization
• Obtaining and logging prior authorizations for procedures as mandated by carriers.

Collections (Self-pay)

• Prepare, review and send patient statements
• Process and send “collections” letters for outstanding balances
• Process all returned mail
• Answer incoming patient billing phone calls, work to resolve patient issues
• Initiating collection calls and setting up and maintaining payment arrangements
• Follow collections process as outlined in FHCHC billing guidelines

Qualifications

High School diploma or GED is required. Experience in a dental setting is essential. The ideal candidate will have 1-2 years of dental authorizations and billing experience; excellent Interpersonal skills and accuracy with attention to detail are a must.

The selected candidate will have the ability to work in a team environment or independently; to meet all established deadlines, metrics and assignment goals at all times and have oral and written proficiency in English. Bi-lingual in English and Spanish is highly preferred.

He/she must be able to use computer and multi-lined telephones; have an understanding of dental terminology and knowledge and experience in billing and authorization practices specific to Medicaid

Direct reports

None

OSHA Status

Category III—Low Risk Position

Generally works in an office environment with no exposure to bloodborne pathogens

Physical requirements

Physical Demands: Requires walking, bending, sitting, standing, writing, reading, telephone use, data input into computer, pulling medical records,

Mental Demands: Ability to cope with continual changing priorities under potentially stressful conditions

Manual Dexterity Required: Ability to use a keyboard, telephone.

American with Disabilities Requirements

External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job specific functions (listed within each job specific responsibility) either unaided or with the assistance of a reasonable accommodation to be determined by the organization on a case by case basis.

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