• Assist in preparing and submitting appeals for denied medical claims • Review EOBs and error codes to understand claim denials • Support accurate use of CPT and ICD codes under guidance • Assist with claims processing related to workers’ compensation carriers • Help with other billing and administrative tasks as assigned

• Support and provide coding and compliance training to clinical personnel, billing, and/or other client staff. • Establish effective communication with clinical staff, and/or hospital staff to address documentation, coding, and reimbursement issues. • Use knowledge of coding and compliance guidelines to identify potential billing / reimbursement issues. • Participate in special audits and system administration as necessary. • Perform diagnosis data submissions to Client, Vendors and internal Stakeholders • Develop monthly productivity and revenue projections • Responsible for chart assignment oversight and monitoring accounts on hold • Prepare data collection reports for leadership • Monitor diagnosis submission progress; Audit diagnosis submission files to ensure accuracy • Review, analyze and oversight of prebill/post bill reviews and pending accounts • Work to resolve workflow, systems and complex matters related to coding

• Analyze and interpret complex records in order to identify and accurately bill for services with the appropriate ICD-10 and CPT/HCPCS codes. • Assign/sequencing billing codes in compliance with third party payor requirements. • Obtain clarification when presented with conflicting or non-specific documentation, when necessary. • Review coding-related denials from payors and make recommendations to resolve claims based on payer guidelines.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Are you experienced in dental insurance billing and coding? Join Diamond Braces as a Biller! Enjoy growth opportunities, great benefits, and the flexibility of a potential remote work environment. Ready to make insurance billing your business? We’d love to meet you! Essential Functions: - Insurance Billing: Accurately prepare and submit insurance claims, including working with state-sponsored insurance programs such as Medicaid. - Coding Compliance: Ensure all billing codes are accurate and comply with regulatory requirements, minimizing claim rejections and delays. - Follow Up on Claims: Track and follow up on outstanding claims to ensure timely payment, addressing any issues or discrepancies as they arise. - Patient Account Management: Assist with patient billing inquiries, providing clear and accurate information regarding their insurance coverage and out-of-pocket costs. - Maintain Accurate Records: Keep detailed records of all billing activities, ensuring compliance with legal and regulatory standards. - Collaborate with the Team: Work closely with the billing department and other team members to ensure seamless billing operations. - Stay Informed: Keep up to date with changes in insurance regulations, billing practices, and coding requirements to ensure compliance and accuracy. - Stay Flexible: Be ready to handle additional tasks as required, adapting to the dynamic needs of the practice. Qualifications - 3+ years of experience in insurance billing and coding, including working with state-sponsored insurance programs such as Medicaid. - Strong understanding of medical and dental billing codes and practices. - Excellent organizational and communication skills. - Proficiency in billing software and technology. - Ability to work independently, especially in a remote setting. - Commitment to accuracy and compliance. Benefits - Competitive salary based on experience and qualifications. - Health, Dental, and Vision insurance packages. - Paid Time Off (PTO). - 401(k) with company match. - Discounted orthodontic care for you and your family. - Ample growth & advancement opportunities. - Potential for remote work. Company Description At Diamond Braces, we believe in improving lives through healthier smiles. Our mission is to provide orthodontic care that is affordable, accessible, and delivered with amazing customer service—the 'AAA Experience.' We’re committed to making every smile count, and we live by our "No Smile Left Behind" philosophy.