Job Description Summary The Dental Billing Specialist is responsible for billing, coding and modifier review, claims processing, payment posting and reconciliation, accounts receivable management, insurance follow-up, patient account resolution, payment plan administration, and related revenue cycle activities. The position supports accurate and timely reimbursement through claim review and submission, denial management, account reconciliation, charge review, compliance-focused auditing, and effective communication with patients, providers, staff, students, and third-party payers. Entity Medical University of South Carolina (MUSC - Univ) Worker Type Employee Worker Sub-Type Classified Cost Center CC000058 CDM Dean Finance & Administration Pay Rate Type Hourly Pay Grade University-GEN08 Pay Range 46,206.00 - 62,322.00 - 78,540.000 Scheduled Weekly Hours 40 Work Shift Job Description 30%: Review charges within Charge Review and Modifier Review work queues to identify coding, modifier, documentation, or billing issues that may affect accurate claim submission and reimbursement. Research and correct claim, charge, coding, and modifier errors through review of clinical documentation, EHR records, payer responses, and account activity. Perform account and chart audits to verify coding accuracy, account balances, claim integrity, and supporting documentation before billing follow-up or correspondence is completed. Post and reconcile insurance and patient payments, electronic remittances, and paper explanation of benefits (EOBs). Establish, monitor, and maintain payment plans for eligible patients in accordance with MUSC and CDM policies. Process claim corrections, reconsiderations, appeals, and resubmissions and provide supporting documentation when appropriate to resolve denials and support reimbursement. 30%: Respond to patients and responsible parties regarding account balances, billing questions, insurance claims, payments, and payment arrangements. Respond to patient MyChart messages and Secure Chat requests from CDM faculty, staff, and students regarding billing and patient account concerns. Monitor accounts receivable and perform timely follow-up on unpaid, denied, underpaid, rejected, and aging claims. Research claims incorrectly processed as out-of-network and work with participating insurance carriers to request correction or reprocessing when appropriate. Research missing insurance payments and remittances and initiate follow-up to ensure payments are properly identified, posted, and reconciled. Identify third-party payer payments, research deposited funds, and coordinate the transfer or correction of misapplied or misplaced payments to the appropriate patient account. Review and process paper and electronic correspondence requiring billing, payment, or claims follow-up and document actions taken within the patient account. Research and resolve credit balances, unapplied payments, and overpayments. Process appropriate refunds in accordance with MUSC and applicable State policies. Maintain complete and accurate billing, payment, claim, and accounts receivable records. Identify recurring account, denial, reimbursement, or collection trends and escalate significant concerns to leadership. 30%: Correct patient demographic, guarantor, coverage, and insurance information within the EHR when necessary to support accurate billing and claim adjudication. Perform insurance verification and identify eligibility, coverage, coordination-of-benefits, or other discrepancies requiring resolution before or during billing follow-up. Communicate timely and accurately with CDM faculty, residents, staff, and students regarding billing, insurance, and patient account issues. Prepare routine and ad hoc reports related to missing charges, charge review, unapproved charges, payment activity, accounts receivable, and billing trends. Assist leadership with escalated and complex patient account matters by researching account history, claims, payments, adjustments, documentation, and other relevant information and coordinating resolution. 10%: Serve as a resource and point of contact for CDM faculty, staff, and students regarding coding, billing, patient accounts, and related policies and procedures. Provide guidance and support regarding billing and coding processes, account resolution, and applicable CDM/MUSC procedures. Provide professional and courteous customer service to patients, responsible parties, payers, faculty, staff, and students while addressing billing questions, account concerns, insurance issues, and payment-related inquiries. Participate in assigned special projects, process-improvement initiatives, workflow development, and training activities. Perform other duties as assigned. Additional Job Description Minimum Requirements: A high school diploma and three years professional experience in a related area such as accounting, auditing, finance or commercial lending. A bachelor's degree with multiple accounting courses may be substituted for two years of the required work experience. Physical Requirements: (Note: The following descriptions are applicable to this section: Continuous - 6-8 hours per shift; Frequent - 2-6 hours per shift; Infrequent - 0-2 hours per shift) Ability to perform job functions in an upright position. (Frequent) Ability to perform job functions in a seated position. (Frequent) Ability to perform job functions while walking/mobile. (Frequent) Ability to work indoors. (Continuous) Ability to work in confined/cramped spaces. (Infrequent) Ability to bend at the waist. (Infrequent) Ability to squat and perform job functions. (Infrequent) Ability to fully use both hands/arms. (Continuous) Ability to perform repetitive motions with hands/wrists/elbows and shoulders. (Frequent) Ability to reach in all directions. (Frequent) Possess good finger dexterity. (Continuous) Ability to maintain tactile sensory functions. (Continuous) Ability to lift and carry up to 15 lbs., unassisted. (Infrequent) Ability to lift objects, up to 15 lbs., from floor level to height of 36 inches, unassisted. (Infrequent) Ability to lower objects, up to 15 lbs., from height of 36 inches to floor level, unassisted. (Infrequent) Ability to push/pull objects, up to 15 lbs., unassisted. (Infrequent) Ability to maintain 20/40 vision, corrected. (Continuous) Ability to see and recognize objects close at hand. (Continuous) Ability to see and recognize objects at a distance. (Continuous) Ability to match or discriminate between colors. (Continuous) Ability to determine distance/relationship between objects; depth perception. (Continuous) Good peripheral vision capabilities. (Continuous) Ability to hear and/or understand conversations. (Continuous) Ability to perform gross motor functions with frequent fine motor movements. (Continuous) Additional New Requirements: Computer literacy. If you like working with energetic enthusiastic individuals, you will enjoy your career with us! The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need. Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees Thank you for wanting to be part of the Medical University of South Carolina team. Whether you want to teach the next generation of health care leaders, innovate new business models, discover the next breakthrough or provide patient care, there's a role for you that fuels your passion and takes advantage of your skills. There are career opportunities available in academics, research, hospital medicine, physician practices and support services, from patient billing to IT. As an applicant, you can search jobs for all MUSC entities as well as search by category and location. MUSC attracts more than $250 million annually in research funding, making it the biggest magnet for biomedical, extramural research dollars of all institutions of higher learning in South Carolina. The Clinical and Translational Science Award (CTSA) Program aims to advance clinical and translational science to increase the speed at which new treatments become available to patients. MUSC Health, the clinical enterprise, operates a 750 bed medical center, which includes a nationally recognized Children’s Hospital, the Ashley River Tower (cardiovascular, digestive disease, and surgical oncology), Hollings Cancer Center (one of fewer than 70 elite National Cancer Institute designated centers), a Level I Trauma Center and the Institute of Psychiatry. In addition, there are more than 100 outreach clinics, hospital/health system affiliations, and telehealth sites. U.S. News & World Report placed us among the top one percent of all American hospitals, with 11 specialties in the top 50. The MUSC Medical Center is also one of only three Magnet® designated hospitals in South Carolina.

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