Insurance Specialist – Dental & Medical

Job Title: Insurance Specialist – Dental & Medical
Location: Chapel Hill, NC 27514
Duration: 12 Months+
 
Position Summary:
This Insurance Specialist role supports both dental and medical insurance services within the School of Dentistry. The position is responsible for all aspects of billing and reimbursement, working with private dental insurance companies and managed care organizations. It requires specialized knowledge of industry billing standards, insurance protocols, and a strong understanding of accounts receivable processes.
 
Essential Responsibilities:

• File dental insurance claims and pre-treatment estimates for privately insured patients.
• Obtain and submit required documentation for claims processing (e.g., x-rays, chart notes, letters of necessity).
• Investigate denied claims, follow up as needed, and submit appeals.
• Verify insurance cards, explanations of payment, provider narratives, and consent forms.
• Regularly audit patient records for billing, coding, and documentation accuracy.
• Maintain effective communication with insurance companies and utilize their portals.
• Collaborate with contracted insurance carriers to ensure accurate and timely reimbursements.
• Ensure compliance with HIPAA regulations and privacy practices.
• Perform other duties as assigned.

 
Qualifications:
Education:

• [Not specified]

 
Experience:

• Experience with dental and medical billing, reimbursement, and insurance claim processes required.
• Familiarity with dental/medical terminology and procedural/diagnostic coding.
• Experience in electronic claims processing and working with multiple insurance vendors.

 
Skills & Competencies:

• Knowledge of dental and medical cross-coding practices.
• Strong understanding of insurance industry billing standards.
• Proficiency in electronic claims processing systems.
• Effective communication and deductive reasoning skills.
• Ability to audit and maintain accurate billing and documentation.
• Ability to interpret and apply insurance policies and contracts.
• Strong organizational skills and attention to detail.
• Compliance with HIPAA standards and confidentiality requirements.