Role Description
The 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.
-
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 flags 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 contributes 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 NADGβs values, culture, and βCore 3β: 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.
Qualifications
-
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.
Requirements
-
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.