How to Be Dental Billing Specialist - Job Description, Skills, and Interview Questions

Jan 12, 2020 / 5 Minutes Read / By Albert

How to Become

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The effect of an inefficient dental billing specialist can cause a decrease in revenue for a dental practice. This can lead to a decrease in patient satisfaction since the dentist may not be able to provide the same level of care due to financial constraints. it may lead to a decrease in staff morale since there will be fewer funds available to hire additional staff or pay existing ones.

Furthermore, it can lead to a decrease in referrals as patients are less likely to recommend the practice if they are not pleased with the service they receive. Lastly, it can have a negative impact on the reputation of the practice if the billing issues are not addressed in a timely manner.

Steps How to Become

Obtain a high school diploma or equivalent. Most employers require a high school diploma or equivalent, such as a GED, in order to become a dental billing specialist.
Complete a postsecondary certificate program. Many employers prefer to hire dental billing specialists who have completed a postsecondary certificate program in dental billing and coding. These programs typically take about nine months to complete and provide instruction in topics such as medical terminology, anatomy and physiology, and coding systems.
Obtain certification. To show mastery of the field, many employers require dental billing specialists to obtain a certification from an organization such as the American Health Information Management Association (AHIMA). To obtain certification, applicants must pass an exam that covers topics such as medical coding, billing processes, and healthcare compliance.
Gain experience. Most employers prefer to hire dental billing specialists who have prior experience in the field. This can be obtained through internships or volunteer positions at medical offices.
Stay current on industry trends. Since healthcare is an ever-evolving field, its important for dental billing specialists to stay up to date on industry trends so they can effectively manage patient accounts and process claims. This can be done through continuing education courses, professional development conferences, or reading industry publications.

The lack of an ideal and efficient dental billing specialist can have a significant impact on the bottom line of a dental practice. Poor billing practices can lead to lost revenue, denied or underpaid insurance claims, and inaccurate information in patient records. Furthermore, improper coding may lead to costly penalties and even criminal charges.

On the other hand, when billing is handled properly, the practice can enjoy increased patient satisfaction, more accurate financial statements, and improved cash flow. An ideal and efficient dental billing specialist should be knowledgeable about the latest coding regulations, be able to effectively communicate with insurance companies, and have excellent organizational skills.

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Job Description

Verify and enter dental insurance claims.
Follow up on unpaid or rejected dental claims.
Submit electronic and manual claims.
Contact insurance companies to resolve claim issues.
Review and adjust claims according to insurance regulations and procedures.
Maintain accurate records of billing and follow-up activities.
Monitor accounts receivable and payment status.
Reconcile patient accounts and resolve discrepancies.
Answer patient inquiries regarding billing and payments.
Generate reports for management review.

Skills and Competencies to Have

Knowledge of dental coding and billing procedures
Familiarity with insurance regulations, policies and procedures
Experience with medical terminology
Ability to use computerized billing systems
Ability to multitask and manage multiple accounts simultaneously
Detail-oriented and organized
Excellent communication and customer service skills
Ability to troubleshoot billing issues
Ability to handle confidential information with discretion
Proficiency in Microsoft Office Suite

The job of a Dental Billing Specialist requires a special set of skills in order to accurately process and manage all the financial transactions related to dental services. The ability to accurately and quickly process complex billing and coding information is paramount for a successful Dental Billing Specialist. A thorough knowledge of the coding systems and specific payer requirements, as well as a working knowledge of the various software programs and databases used in the field, are also essential.

excellent organizational skills, attention to detail, problem-solving skills, and communication skills are also important characteristics for a successful Dental Billing Specialist. Having these skills allows a Dental Billing Specialist to accurately process claims and payments, reducing the risk of errors that can lead to denied claims, delayed payments, and dissatisfaction on the part of patients and providers.

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Frequent Interview Questions

What experience do you have with dental billing and coding?
How familiar are you with insurance claims processing?
What strategies have you used to ensure accurate billing procedures?
Describe a time when you had to resolve a complex billing issue.
How do you stay up-to-date on changes in the dental coding and billing system?
What techniques do you use to maintain accurate patient records?
How do you handle difficult conversations with insurance companies or patients?
How do you manage multiple tasks and prioritize them?
How did you handle a situation when an insurance company denied a claim?
What steps do you take to ensure compliance with federal and state regulations?

Common Tools in Industry

Claim Management Software. This software helps dental billers manage insurance claims and reimbursement processes. (eg: Kareo)
Practice Management Software. This software helps dental billers manage patient information and medical records. (eg: Dentrix)
Accounting Software. This software helps dental billers track payments and balance accounts. (eg: QuickBooks)
Electronic Claims Submissions. This software allows dental billers to submit claims electronically, reducing processing time. (eg: DentalXchange)
Payment Processing Software. This software helps dental billers process payments from patients, insurance companies, and other sources. (eg: PaySimple)
Coding Software. This software helps dental billers accurately code services and fees, ensuring claims are processed correctly. (eg: CodeLink)
Patient Portal Software. This software allows patients to view their medical records and make payments online. (eg: NextGen)

Professional Organizations to Know

American Academy of Dental Coders (AADC)
American Association of Professional Coders (AAPC)
National Association of Dental Plans (NADP)
Academy of Dental Management Consultants (ADMC)
American Association of Dental Office Managers (AADOM)
National Health Care Anti-Fraud Association (NHCAA)
National Association of Insurance Commissioners (NAIC)
Healthcare Financial Management Association (HFMA)
American Dental Association (ADA)
Medical Group Management Association (MGMA)

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Common Important Terms

Credentialing. The process of obtaining and verifying the qualifications of a medical or dental professional in order to provide services to a healthcare facility or insurance company.
Insurance Verification. The process of verifying the patients insurance coverage before providing services.
Claims Processing. The process of submitting and tracking claims to insurance companies, ensuring that the insurance company pays all or some of the fees for the services provided.
Fee Schedules. A list of fees set by a particular insurance company or healthcare facility for specific services.
Electronic Medical Records (EMR). A secure computerized system for managing patient records and clinical data.
Revenue Cycle Management (RCM). The process of managing the financial aspects of a healthcare practice, including claims processing, billing, and collections.
ICD-10 Coding. A set of codes used to classify medical diagnoses and procedures for billing purposes.
HIPAA Compliance. Standards set by the Health Insurance Portability and Accountability Act (HIPAA) for handling and protecting patient information.

Frequently Asked Questions

What is a Dental Billing Specialist?

A Dental Billing Specialist is a professional who specializes in coding and billing for dental services. They are responsible for ensuring that dental claims are accurately processed and that reimbursements are received in a timely manner.

What qualifications are needed to become a Dental Billing Specialist?

To become a Dental Billing Specialist, you typically need to have a high school diploma or equivalent and have experience in medical or dental billing. Additionally, most employers prefer to hire candidates who are Certified Professional Coder (CPC) certified.

What types of duties might a Dental Billing Specialist be responsible for?

A Dental Billing Specialist may be responsible for various duties, including verifying patient information, preparing and submitting claims, coding procedures, tracking payments, and resolving claim rejections and denials.

What is the average salary of a Dental Billing Specialist?

According to the U.S. Bureau of Labor Statistics, the median annual wage for Dental Billing Specialists in May 2019 was $41,790.

What other jobs might someone with experience as a Dental Billing Specialist be qualified for?

With experience as a Dental Billing Specialist, one may also be qualified for similar positions such as Medical Biller, Claims Adjuster, or Revenue Cycle Analyst.