Job Title:

Customer Service Agent Position Summary The Customer Service Agent performs a variety of insurance billing, data entry, and general front office tasks and duties including, but not limited to generating and billing out claims, benefits eligibility verification, documenting diagnosis and production, tracing payments, assisting with patient dismissal, scheduling, and answering the telephone. Responsibilities Enter treatment diagnosis and production into the West Coast Dental System on a daily basis Print and submit treatment authorizations requests on a daily basis Bill out claims on a daily basis / Bill out supplemental claims on a daily basis (HMO) Print HMO encounter forms daily and mail on a monthly basis Prepare and submit specialty referrals on a daily basis Process all notices of authorization received and call the patients (or send postcards) on a weekly basis Call approved specialty patients to schedule appointments Respond to all re-submission of turnaround documents from insurance companies, requesting additional information, such as x-rays, on a daily basis Maintain accurate billing data, reporting/supporting documents, records, and reports Work with dental staff members or other billing department staff on billing matters Post explanations of benefits on insurance and Denti-Cal as soon as they are received in the office Prepare or run an aging report of accounts that are over 30 days old and review outstanding Insurance and Denti

• Cal balances and follow up with collection calls Trace all outstanding claims on a weekly basis Answer patient questions concerning claims, insurance, HMOs, Denti-Cal, etc.

Follow-up with patients as needed through reminder phone calls, notices, and letters Answer telephones and schedule appointments Verify patient benefits eligibility Collect patient payments, post payments on the West Coast Dental System, and print receipts Assist the Office Manager, as requested, with printing, reviewing, and faxing collection report, day sheet, and summary report to the Support Center at closing each day Assist the Office Manager with collections, reconciliation and deposit preparation at closing each day Perform data entry and file patient charts as instructed Attend and participate in staff meetings and team huddles Comply with Federal and State legislation pertaining to all billing related matters Maintain strict compliance with State, Federal, and other pertinent laws or regulations, (e.g., OSHA, WC, Dental Board, HIPPA, ADA, FEHA, DOL, HR policies and practices) Other Duties and Requirements Check-in/Check-out patients and prepare charts Order all billing supplies as needed Other duties as assigned by the Office Manager, Regional Manager, and/or Dentists Knowledge, skills, and abilities High School diploma or equivalent (GED) required Dental billing experience (insurance, Denti-Cal, HMO) required

Bilingual:

English & Spanish required (if the geographic location of the office does not require the applicant to be bilingual, applicants who only speak English may be considered) Proficient with PC and outlook Knowledge with NEA-Fast Attach and Dental Exchange Strong written and verbal communication skills Ability to work in a fast paced environment and able to multitask Ability to organize insurance, HMO, Denti-Cal information, claims, encounters, tracers, etc. Ability to maintain professional demeanor staff and patients Work Schedule The Customer Service Agent will be notified of the work schedule on a weekly, bi-weekly, or monthly basis. The Customer Service Agent s schedule is subject to change (daily/weekly hours may increase or decrease) according to the needs of the practice. Evening and weekend hours may be required. This position is paid on an hourly basis. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this position, the employee is regularly required to stand, sit, and walk; talk, hear, and smell; and use hands, fingers, and wrists (manual dexterity and hand-eye coordination) to handle or feel the mouth/teeth and gums of patients, as well as objects, tools, or controls associated with the dental field. The employee is frequently/occasionally required to reach; lift and/or move up to 25 pounds; and balance, stoop, bend, squat, kneel, crawl, climb, twist, pull, and crouch. The essential functions of this position will result in the following: hazardous exposure (chemical and infections

• constantly; non ionizing radiation (welding flash, microwaves, sun, etc.
• frequently; radiation (x-ray, radioactive, isotopes, etc.
• constantly; noise (loud/repetitive, 85 decibels per OSHA standard
• constantly; and personal protective equipment (

PPE:

respiratory masks, latex gloves, face shields, etc.

• constantly.

Work Conditions and Risk General Dental Office conditions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The dental office environment may result in employees being exposed to toxic chemicals, radiation, infectious bodily fluids and materials, and increased noise level. This position assumes high risk. Independent Action Under the general supervision of the Office Manager, regular duties performed by the Biller may require occasional independent judgment. The Biller must consult with her/his supervisor regarding patient problems or confrontation, policy issues, expenditures, and unusual problems. Limitations and Disclaimer The above job description is meant to describe the general nature and level of work being performed; it is not intended to be construed as an exhaustive list of all responsibilities, duties, skills, and physical demands required for the position. This job description is subject to possible modification to reasonably accommodate disabled individuals. Some requirements may exclude individuals who pose a direct threat or significant risk to health and safety of themselves or other employees. This job description in no way states or implies that these are the only duties to be performed by anyone occupying this position. Employees are required to follow any other job-related instructions and to perform other job-related duties requested by their supervisor in compliance with State and Federal law The job requirement represents the minimum levels of knowledge, skills, and/or abilities. To perform this job successfully, the employee must possess the abilities to perform each duty proficiently. Continued employment remains on an at-will basis.