RCM Specialist, Dental

About the Job
We are seeking an experienced and detail-oriented Revenue Cycle Management (RCM) Specialist with a strong background in dental billing and coding. The ideal candidate will have a proven track record in optimizing revenue cycles, managing claims efficiently, and ensuring seamless financial operations within dental practices.

Key Responsibilities

1. Dental Billing and Coding Expertise
   • Mastery of CDT codes, ADA claim forms, and insurance billing protocols.
   • Efficiently submit claims to minimize denials and maximize reimbursements.
2. Practice Management Systems (PMS) Knowledge
   • Proficient in Dentrix, Eaglesoft, Open Dental, and other similar systems.
   • Streamline workflows for insurance claims and patient account management, enhancing overall efficiency.
3. Insurance Management
   • Verify patient insurance eligibility and benefits accurately.
   • Manage coordination of benefits (COB) and secondary insurance claims, ensuring proper payment distribution.
4. Accounts Receivable (AR) Management
   • Monitor and resolve aged AR claims in a timely manner.
   • Collaborate with insurance providers to expedite claims processing and payment.
5. Payment Posting
   • Accurately post insurance and patient payments to respective accounts.
   • Maintain up-to-date, reconciled account balances and ensure all transactions are properly documented.
6. Compliance and Reporting
   • Ensure adherence to HIPAA standards and dental billing regulations.
   • Generate and analyze reports to track financial performance, providing actionable insights for improvement.

Skills and Qualifications

• Experience: Minimum of 2 years of RCM experience in U.S.-based dental practices.
• Technical Proficiency: Hands-on experience with automated billing tools and Microsoft Excel.
• Analytical & Problem-Solving Skills: Ability to identify, resolve, and prevent claim denials.
• Communication Skills: Strong ability to communicate billing and insurance issues clearly with patients and team members.
• Collaboration: Work effectively with cross-functional teams to optimize processes and improve revenue cycle performance.