Experienced Remote Biller - Appeals Specialist: Join the Team at Rodeo Dental & Orthodontics and Elevate Your Career in Healthcare Revenue Cycle Management

About Us

Rodeo Dental & Orthodontics is a pioneering multi-specialty dental group that's revolutionizing the way dental care is delivered across the United States. With over 100 award-winning doctors and 40+ locations spanning Texas, Colorado, and Arizona, we're committed to providing top-notch general dentistry, orthodontics, endodontics, oral surgery, and pediatric dental services to our patients. Our team is driven by a passion for excellence, innovation, and patient satisfaction, making us an ideal place to grow your career.

Job Summary

We're seeking an experienced and detail-oriented Remote Biller - Appeals Specialist to join our dynamic team. As an Appeals Specialist, you'll play a critical role in reviewing unpaid claims from insurance plans, following up with insurance companies, and requesting reconsideration for payment on denied claims. If you have a strong background in dental coding, Medicaid, and PPO claim adjudication, and excellent communication skills, we encourage you to apply for this exciting opportunity.

Key Responsibilities

• Review and analyze unpaid claims from insurance plans to identify potential appeals opportunities
• Follow up with insurance companies after 30 days of filing to ensure timely payment
• Request reconsideration for payment on denied claims with supporting documentation
• Identify delinquent accounts, aging periods, and payment resources to optimize revenue cycle management
• Contact patients for additional insurance information and resubmit dental claims to the appropriate payer
• Review Explanation of Benefits and patient history for accurate reimbursement and discounts by contracted managed care companies
• Research and process rejected claims, resubmitting with corrected information as needed
• Assist with processing insurance and patient refunds in a timely and efficient manner
• Process insurance-related correspondence and respond to inquiries from patients, insurance companies, and internal stakeholders
• Develop and maintain relationships with key personnel at dental payers to facilitate claim reconsiderations
• Maintain strict confidentiality and adhere to regulatory requirements
• Perform other duties as assigned to support the success of our revenue cycle management team

Essential Qualifications

• Knowledge of Dental Coding: Familiarity with dental coding principles and practices is essential for this role
• Dental Medicaid and PPO Claim Adjudication: Experience with Medicaid and PPO claim adjudication is highly desirable
• Dental Benefits and Verification of Coverages: Understanding of dental benefits and verification of coverages is critical for accurate reimbursement
• Legal and Regulatory Provisions: Knowledge of legal and regulatory provisions related to collection activities is necessary to ensure compliance
• Computer Applications and Typing Skills: Proficiency with computer applications and fast typing skills are required for efficient data entry and communication
• Communication Skills: Excellent communication skills are essential for interacting with internal operations, patients, and insurance companies
• Valid Driver's License: This position may require travel to different work sites, so a valid driver's license is necessary

Preferred Qualifications

• Bachelor's degree in a related field (e.g., healthcare administration, business)
• Experience in healthcare revenue cycle management or a related field
• Familiarity with dental practice management software and electronic health records
• Certification in medical billing or coding (e.g., CPC, CCS)

Skills and Competencies

• Analytical and Problem-Solving Skills: Ability to analyze complex data and identify solutions to optimize revenue cycle management
• Communication and Interpersonal Skills: Excellent communication and interpersonal skills for interacting with patients, insurance companies, and internal stakeholders
• Attention to Detail: High level of accuracy and attention to detail to ensure compliance with regulatory requirements and accurate reimbursement
• Organizational and Time Management Skills: Ability to prioritize tasks and manage multiple projects simultaneously in a fast-paced environment

Career Growth Opportunities and Learning Benefits

At Rodeo Dental & Orthodontics, we're committed to supporting the growth and development of our team members. As a Remote Biller - Appeals Specialist, you'll have opportunities to:

• Advance your career in healthcare revenue cycle management
• Develop new skills and expertise in dental coding, Medicaid, and PPO claim adjudication
• Participate in ongoing training and education to stay up-to-date on regulatory requirements and industry best practices
• Collaborate with a team of experienced professionals who are passionate about delivering exceptional patient care

Work Environment and Company Culture

Our company culture is built on a foundation of respect, integrity, and teamwork. As a remote team member, you'll have the flexibility to work from home and enjoy a better work-life balance. We offer:

• A dynamic and supportive work environment that encourages collaboration and innovation
• A team of experienced professionals who are passionate about delivering exceptional patient care
• Ongoing training and education to support your growth and development
• A comprehensive benefits package, including medical, dental, vision, and life insurance

Compensation and Benefits

We offer a competitive salary and benefits package, including:

• Competitive salary range: $50,000 - $70,000 per year (dependent on experience)
• Comprehensive benefits package, including:
  • Medical, dental, and vision insurance
  • Company-paid life insurance
  • Short-term and long-term disability
  • Health savings account
  • Supplemental life insurance
  • 401(k) plan
  • Accident and critical illness insurance
  • Identity protection
  • Team member assistance program
• PTO and holidays

Equal Opportunity Employer

Rodeo Dental & Orthodontics is an equal opportunity employer committed to diversity and inclusion. We're proud to offer a workplace that's free from harassment and discrimination, where all employees are treated with respect and dignity.

How to Apply

If you're a motivated and detail-oriented professional looking for a challenging and rewarding role, we encourage you to apply for this exciting opportunity. Please submit your resume and cover letter to [insert contact information]. We look forward to hearing from you!