US Dental Billing Manager

Job Title: US Dental Billing Manager (Washington & California Medicaid Specialist)

Location: Philippines | Remote

Schedule: U.S. Business Hours/Night Shift

About the Role

We are seeking an experienced and detail-oriented US Dental Billing Manager with specialized expertise in Washington and California Medicaid State Plans. In this role, you will oversee end-to-end dental revenue cycle management (RCM), lead daily billing operations, maintain low aging balances, and ensure strict compliance with state-specific billing guidelines.

The ideal candidate possesses strong managerial experience and hands-on proficiency in every step of the dental billing lifecycle—from eligibility verification to complex claim resolution.

Qualifications & Requirements

MUST-HAVES (Non-Negotiable):

• Proven Managerial Experience: Prior supervisory or managerial experience leading a team within US Dental Billing / RCM.
• State-Specific Medicaid Knowledge: Deep, demonstrable expertise in Washington State (WA Medicaid / Apple Health) and California (CA Medicaid / Denti-Cal) dental guidelines, coding, and submission protocols.

Technical & Practical Skills:

• Full-Cycle Billing Proficiency: Proven hands-on track record in:
• Insurance verification & pre-authorizations
• Claim submission, denial management, and appeals
• Payment posting and ERA/EOT reconciliations
• A/R management and aging bucket reduction
• Strong familiarity with CDT coding, ADA claim forms, and US dental software systems (e.g., Dentrix, Open Dental, EagleSoft, or similar practice management platforms).
• Exceptional analytical skills with high attention to detail.
• Strong verbal and written communication skills for handling payer communications and leadership reporting.

Key Responsibilities

• RCM Operations & Management: Supervise and streamline end-to-end dental billing processes, ensuring maximum collections, minimal denials, and smooth workflow management.
• Medicaid Expertise: Manage and resolve billing requirements specifically tailored to Washington (Apple Health) and California (Denti-Cal) Medicaid State Plans and fee schedules.
• Insurance Verification: Oversee patient eligibility, benefit breakdowns, pre-authorizations, and coverage limitations prior to patient visits.
• Claim Submission & Follow-Up: Ensure clean, accurate claim submissions (electronic and paper) and lead aggressive follow-up on unpaid, pending, or denied claims.
• Payment Posting: Manage accurate and timely posting of insurance payments, patient copays, adjustments, and write-offs.
• A/R & Aging Management: Monitor Accounts Receivable reports, analyze 30/60/90+ day aging buckets, identify trend issues, and implement action plans to keep A/R metrics healthy.
• Team Leadership: Train, mentor, and audit the performance of billing staff to maintain high quality standards and adherence to SOPs.