Under general supervision, this Revenue Cycle Management (RCM) Specialist supports RCM processes including, but not limited to, insurance benefit verification, dental insurance carrier/plan maintenance, dental claims billing and collections tasks assigned to the revenue cycle department for a multi-site oral surgery group in the Raleigh/Durham area of North Carolina. Services of this position may impact the short-term direction, operations and/or financial status of various dental offices. Decisions made have an impact on compliance, resources, and provider service.

Location: Holly Springs/Raleigh, NC area.

RCM Claims Specialist Responsibilities:

• Responsible for assigned projects and processes for an office or office group at a time, including but not limited to insurance verification, claims submission, claims statusing, payment posting, patient accounts receivables, patient billing inquiries, denials and appeals management and or other RCM tasks, as designated.
• Reinforce RCM processes, policies, and compliance items that are in place by working with the Operations, Front office and RCM teams.
• Support Revenue Cycle process and communicate, educate, and collaborate with practice managers.
• Maintain up-to-date knowledge of billing, coding, and productivity auditing
• Maintain knowledge of payer processing and payer policies, Medicaid, and Dental Payers, sometimes medical payers.
• Report trending data with supporting evidence and identify areas of RCM opportunities.
• Meet established production and quality standards as set by RCM Director, Operations Leaders, or practice managers.
• Celebrate personal and team improvements, progress, and success with fellow staff members
• Performs special projects and other duties as assigned.

Revenue Cycle Management Specialist Preferences and Requirements:

• Bachelor's degree in finance, business administration, healthcare administration, or related field or minimum 3-5 years’ experience in a healthcare revenue cycle position.
• Oral surgery billing experience, preferred.
• Strong knowledge of computer skills, Outlook, Word, Excel (pivot tables), and database software skills
• Medical billing knowledge, preferred.
• Possess the ability to work in a constantly changing and fast-paced environment, good judgment skills, and capable of making decisions with attention to detail.
• Must have excellent time management and 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, OSHA, and cybersecurity policies and regulation
• Have strong oral, written, and interpersonal communication skills
• Ability to read, understand, and apply state/federal laws, regulations, and policies.
• Ability to adapt to and train on multiple PMS systems, including DSN.
• Ability to communicate with diverse personalities discreetly, maturely, and professionally.
• 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, from Entry-level to Sr. Leadership