Ortho AR Specialist

Summary 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.

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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