The Petaluma Health Center’s mission is to provide high quality health care, with access for all, in Southern Sonoma County. The Center accomplishes this mission through collaborative, innovative programs, services and referral resources that meet the economic needs of the entire community.
The Petaluma Health Center is a nine-time award winner in the North Bay Business Journal’s Best Places to Work for 2018, 2017, 2016, 2015, 2014, 2013, 2012, 2011 and 2009 and we were named as one of '2015 Healthiest Companies in the North Bay' by the North Bay Business Journal.
We are a Federally Qualified Health Center (FQHC) that provides primary medical care and mental health services to residents of Petaluma, Rohnert Park, Cotati, Penngrove and surrounding areas. We are organized as a private, non-profit corporation and governed by a consumer and community led Board of Directors.
For more information about us, please visit us at www.phealthcenter.org.
Position Title: Dental Billing Specialist
Summary: The Dental Billing Specialist will facilitate the collection of revenue for services rendered through the dental department of the Petaluma Health Center.
Areas of Responsibility:
- Reviews visit documentation and coding and ensures that the clinical notes support the codes and the codes support the clinical notes
- Ensures that correct coding is used to designate the diagnoses and procedures performed; stays current on dental coding
- Ensures that insurance billing is compliant with the coverage, frequency and documentation requirements specific for each insurance type
- Has extensive knowledge of MediCal/DentiCal insurance coverage and documentation requirements
- Responsible of billing under the sliding scale program
- Has extensive knowledge of the Dentrix Enterprise billing module
- Creates electronic billing records for each insurance and billing type
- Ensures Treatment Authorization Requests are generated and submitted for proposed treatment according to the requirements of each insurance type
- Reviews and makes decisions on Treatment Authorization Requests (TARs) with the support of the Dental Billing Manager
- Creates and submits dental benefit claims
- Knows the process of submitting claims for each dental benefit plan and submits as many claims electronically as possible
- Runs monthly statements and submits to Quickbill for distribution
- Ensures that patient records are accurate and complete, and that patient confidentiality is strictly maintained
- Enters payments and reconciles with the Receipts report
- Ensures that patient ledgers balance and the correct adjustment are posted to accounts
- Works on aging report with the guidance of the Dental Billing Manager
- Works with the Dental Billing Manager to keep accounts receivable at equal to or less than one month’s production
- Tracks claims and outstanding balances to ensure timely payment; follows up with insurance claims and delinquent accounts
Front office and Billing Manager support
- Works with front office staff to facilitate collections for services rendered
- Assist patients with billing questions, on the phone and in person; issues receipts.
- Conduct financial consultations with patients as needed
- Ensures all patients have a current financial consent form signed and financial agreement signed with each new treatment plan presented
- Understands the practice’s financial protocols and is prepared to educate patients and staff
- Verifies eligibility and the breakdown of dental benefits for patients prior to their appointment unless done by front office staff
- Works with front office staff to maintain and balance petty cash supply
- Works with the Dental Billing Manager to develop, understand and implement the practice’s billing policies and procedures.
Miscellaneous Billing Tasks
- Processes all mail related to dental billing
- Perform other tasks as assigned by the Dental Billing Manager
- Participates in meetings and work group discussions
- Maintains an appropriate office environment