Ortho AR Specialist

Overview

SummaryThe Orthodontic Accounts Receivable (AR) Specialist is responsible for the timely and accurate execution of insurance claims processing, patient AR follow-up, and resolution of account balances. This position is focused on task-level support for collections, including reviewing EOBs, submitting appeals, correcting billing errors, and contacting payers and patients. The AR Specialist plays a key role in maintaining clean claims, minimizing aging AR, and supporting revenue cycle team goals through dependable daily follow-up activities.

Essential Responsibilities• Reads/analyzes Explanations of Benefits (EOBs) for accuracy; determines appropriate follow-up actions. • Submits dental claims, appeals, and supporting documentation to payers. • Identifies and corrects billing errors and resubmits claims as needed. • Conducts root cause research for denied or unpaid claims. • Uses insurance portals and phone outreach to follow up on claim status. • Bills work-in-progress, secondary and tertiary insurance when applicable. • Reviews remittance advice for underpayments or payment discrepancies. • Escalates recurring payer issues or delays to supervisors as needed. • Initiates & maintains patient AR follow-up for overdue balances, per internal protocols. • Coordinates payment arrangements or flag accounts for further collection activity. • Conducts ledger audits, contract corrections, and AR adjustments with policy alignment. • Responds to practice-level inquiries via email or ticketing system in a timely and professional manner. • Supports Cloud9 optimization and contribute feedback to improve workflows. • Meets assigned productivity benchmarks and team performance goals. • Expected to work all scheduled days and hours, and to report to work on time.• Embraces NADG’s values, culture, and “Core 3”: People First, Access to Care, and Cost Containment.• Supports the NADG Care Cycle and prioritizes delivering best-in-class patient care.• Other duties as assigned.

Experience/Requirements• Minimum of 2 years in dental revenue cycle, including claims billing and patient collections.• Proficiency in Microsoft Office Suite.• Familiarity with insurance portals and eligibility/claim inquiry tools.• Knowledge of insurance payer guidelines and AR workflows.• Experience with Cloud 9 or other orthodontic software preferred.Knowledge, Skills, and Abilities (KSAs)• Attendance & Reliability: Arrives to work on time; dependable, punctual, and demonstrates strong time management skills.

• Cooperation & Teamwork: Works respectfully and effectively with colleagues; contributes meaningfully to help the practice achieve its goals.• Communication Skills: Demonstrates clear, organized, and effective written and oral communication; exhibits strong listening and comprehension abilities.• Customer Service: Provides professional, helpful, and high-quality service to both internal and external customers, addressing patient needs effectively.• Leadership & Decision-Making: Makes thoughtful, well-reasoned decisions; demonstrates resourcefulness and creativity in problem-solving.• Initiative & Flexibility: Takes initiative by seeking additional responsibilities; identifies problems and proposes solutions; adapts well to new challenges and unexpected changes.• Knowledge & Expertise: Possesses a strong understanding of the information, processes, and procedures necessary to perform the role effectively.• Technical Capabilities: Performs job responsibilities with attention to detail, consistency, productivity, and efficiency, in alignment with company and industry standards.• Digital Dentistry: Demonstrates knowledge of digital equipment and software used in the practice, including Open Dental, Primescan, Overjet, and others.

Education/Certifications• High school diploma or equivalent• Additional education or certifications in billing/coding preferred.

Physical/Environmental• This is a sedentary role, requiring prolonged periods of sitting and regular use of a computer and other standard office equipment.• Requires frequent talking, hearing, and visual acuity for computer work and communication.• May occasionally be required to lift items weighing up to 30 pounds.• Work is performed in a private home office environment.• Occasional travel may be required.

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