ROLEDENTIST

Billing and AR Specialist VA

Dentist · Role

Quick answer

A remote billing specialist who owns claim submission, denial management, and AR follow-up as a dedicated function, not a task shared with scheduling or patient service.

What this role owns

The Billing and AR Specialist VA owns the revenue cycle from claim submission through payment posting. This includes daily claim submission, working denials, following up on unpaid claims, and generating the AR reports the practice manager or owner reviews.

The role does not include pre-appointment benefits verification, which belongs to the Insurance Specialist VA role. Separating these functions prevents verification and billing from competing for the same person’s attention.

Why dedicated billing matters

In most dental practices, billing is handled by someone whose primary job is something else: a front desk coordinator who also submits claims, or a dental assistant who handles billing between procedures. The result is that claims age without follow-up, denials go unworked past appeal windows, and AR grows without a clear owner.

A billing VA who does nothing but billing accumulates carrier-specific knowledge, catches denial patterns earlier, and maintains a follow-up cadence that generalist staff cannot sustain.

What the ramp period looks like

Weeks 1 to 2: learning the practice’s PMS billing module, clearinghouse, and current claim submission process. Reviewing the existing AR aging report with the practice manager.

Weeks 3 to 4: handling claim submission independently, with review. Beginning to work 30-plus day claims under supervision.

By Day 60: owning claim submission, denial follow-up, and AR reporting independently. Escalating unusual denials or payer disputes to the practice manager.

What success looks like

Clean claim rate above 95 percent. AR over 90 days as a percentage of total AR trending down. No claim reaches timely filing without a follow-up attempt on record. Recurring denials are identified and reported before they compound into a systemic AR problem.

What this role is not

This role does not handle patient balance collection calls, which require different communication skills and often involve payment plan conversations best handled by someone with authority to negotiate. It does not handle pre-authorization submission, which belongs to the Insurance Specialist role.

See Also

Role spec

Responsibilities

  • Submit clean claims daily from the previous day's production
  • Work denied claims within 5 business days of receipt
  • Follow up on unpaid claims in the 30-plus day AR bucket on a weekly cadence
  • Identify recurring denial patterns and report them to the practice manager
  • Generate a weekly AR aging summary and flag claims approaching timely filing windows
  • Verify secondary insurance coordination and submit crossover claims
  • Post payments and reconcile EOBs against submitted claims

Skills

  • CDT coding and claim form requirements
  • Denial code interpretation and appeal preparation
  • AR aging analysis and prioritization
  • Payer-specific timely filing rules and documentation requirements
  • EOB and ERA reading

Tools

  • Dental practice management software billing module
  • Clearinghouse platform (Availity, Office Ally, or equivalent)
  • Payer portals for claim status and appeal submission
  • AR aging reports

Next operational step

Insurance Claim Status Follow-Up

Related content

Keep exploring

This is one entry in the VA Hiring Circle library. Browse the Dentist Knowledge Hub for more problems, roles, workflows, and systems.

Explore the Dentist Knowledge Hub →