RCM Specialist Ortho

Job Type

Full-time

Description

Position Title: RCM Specialist

Description:

Specialty Dental Brands (SDB) is a leading dental service organization focused on partnering with the best doctors with a proven record of accomplishment of patient care and community involvement. We provide proven operational support, technology, and overall practice management across a nation-wide network of leading class pediatric dentistry, orthodontics, and oral surgery platforms. We are looking for a talented and highly motivated individual who has a natural desire to improve and build new processes and thrive in a start-up culture and rapidly growing business.

RCM Specialists are primarily responsible for supporting RCM functions of the front and back office through training, education, analyzing collections, resolving non-payables special projects, handling inquiries for complex revenue cycle issues, front office auditing, clearing house management, and assistance on any special projects assigned.

Job Type:

•Full-Time

•Hybrid (after onboarding period)

•May require up to 50-75% Travel depending on the need of the practice or region.

•Based in the region you will directly support.

Responsibilities:

•RCM specialists will be responsible for the assigned region's net revenue percentage to ensure the practices increase revenue and decrease RCM errors.

•RCM processes, policies, and compliance items are followed by working with the Regional Directors and RCM Director.

•SME for the Revenue Cycle process and communicate, educate, and train front and back-office RCM processes.

•SME knowledge of billing, coding, and productivity auditing

•SME knowledge of payer processing and payer policies, Medicaid, and Dental Payers, sometimes medical payers.

•Possesses the ability to work in a constantly changing environment, good judgment skills, and capable of making decisions with attention to detail.

•Must have excellent organizational skills and ability to prioritize and coordinate workload with high proficiency and accuracy.

•Must have excellent analytical and problem-solving skills.

•Maintains strict confidentiality of patient's medical records and adherence to all HIPAA and ACHC policies and regulations.

•Must be extremely accurate with attention to details, policies, and procedures.

•SME knowledge of billing, coding, and productivity auditing

•Ability to report trending data and identify areas of RCM opportunities.

•Must develop and update multiple Action Plans and produce positive revenue outcomes.

•Must be agile to move from project to project at a quick pass or be able to change gears quickly.

•Meet established production and quality standards as set by Specialty Dental Brands

•Excellent and accurate calculator and computer skills. Including the ability to use Microsoft Excel, Microsoft Word, E-Mail. Excel and Data will be a major function of the job; therefore, you must be able to work with Excel functions and pivot tables.

•Performs special projects and other duties as assigned.

•Immediate to High-level knowledge of medical and dental billing rules, such as coordination of benefits, modifiers, Medicare, and Medicaid, and understanding EOBs.

•Strong oral, written, and interpersonal communication skills

Strong time management and organizational skills

•Strong knowledge of Outlook, Word, Excel (pivot tables), and database software skills

•Ability to read, understand, and apply state/federal laws, regulations, and policies.

•Ability to adapt to and train on multiple PM systems.

•Ability to communicate with diverse personalities discreetly, maturely, and professionally.

•Ability to remain flexible and work within a collaborative and fast-paced environment.

•Ability to work easily and cooperatively with other departments.

•Ability to work independently and follow through on tasks without direct supervision.

•Ability to work well under pressure in a flexible, diplomatic, and expeditious manner.

•Ability to work with all levels of teams, Entry-level to Sr. Leadership

Organizational Alignment:

•Reports to: RCM Director

•Other Key Relationships: General Manager, VP of Revenue Cycle

Requirements

Required Minimum Qualifications:

•High School Diploma or GED

•At least five (5) years in the healthcare or dental RCM functions.

•At least five (5) years in billing and claims resolution

•At least five (5) years of dental front office RCM functions

•Preferred: CPB (Certified Professional Biller), CMB (Certified Medical Biller), CDC (Certified Dental Coder), CDBS (Certified Dental Billing Specialist). Must be willing to obtain certification if asked.
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