RCM Specialist, Dental

1 week ago

Capital District, Philippines ZIA Full time

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
  • 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.
  • 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.
  • Insurance Management
    • Verify patient insurance eligibility and benefits accurately.
    • Manage coordination of benefits (COB) and secondary insurance claims, ensuring proper payment distribution.
  • Accounts Receivable (AR) Management
    • Monitor and resolve aged AR claims in a timely manner.
    • Collaborate with insurance providers to expedite claims processing and payment.
  • 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.
  • 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.
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