[Hiring] Senior Remittance Specialist @Dental Care Alliance

Role Description

The Senior Remittance Specialist – Training & Optimization is responsible for accurate insurance payment posting and reconciliation while also serving as the subject matter expert for onboarding, training, and continuous optimization of remittance workflows. This is a 100% remote position.

Key Responsibilities

• Payment Posting & Reconciliation
  • Accurately post all insurance payments, adjustments, and denials to client accounts in a timely and compliant manner.
  • Review and reconcile check deposits, EFTs, and lockbox reports to ensure completeness and accuracy.
  • Ensure all payments are posted in accordance with payer contracts and client-specific rules.
  • Maintain a high level of productivity while meeting or exceeding quality standards (99%+ accuracy).
  • Ensure all payments are matched and reconciled on Reconciliation Reports, including clear documentation for discrepancies.
  • Manage the Zentist portal daily to confirm posted payments and completed deposits.
  • Assign denied claims to Denial Management and A/R teams within Denticon’s task manager.
  • Monitor and process Electronic Remittance Advice (ERA) through DentalXChange.
  • Resolve payments received without Explanation of Benefits (EOBs).
  • Obtain ERA/EOB files from multiple sources, including DentalXChange, Zentist, payer portals, and direct payer communication.
  • Escalate recurring payer issues or payment variances to the Revenue Cycle Manager.
  • Maintain accurate workload reporting within the Daily Tracker for payment posting, reconciliation, and ERA processing.
  • Pre-audit and escalate fee discrepancies to the Fees Team.
  • Initiate refund tickets for payer overpayments.
  • Adhere to HIPAA requirements and all internal compliance standards.
• Training, Documentation & Optimization
  • Serve as the lead trainer and subject matter expert for the Payments & Remittance function.
  • Deliver structured onboarding and training for new hires, covering systems, posting standards, reconciliation requirements, and quality expectations.
  • Coach and support team members to reinforce accuracy, efficiency, and compliance.
  • Create, update, and maintain Standard Operating Procedures (SOPs) for all remittance and payment posting workflows.
  • Ensure SOPs remain current, audit-ready, and consistently followed across the team.
  • Identify training gaps, quality trends, and process improvement opportunities; partner with leadership on optimization initiatives.
  • Support internal audits and quality reviews through strong documentation and standardized workflows.
  • Act as an escalation and knowledge resource for complex posting, reconciliation, and payer-specific scenarios.

Performance Metrics (KPIs)

• Productivity: Post 30+ payments/adjustments per hour worked; auto-posted payments included.
• Accuracy: Maintain a minimum 99% accuracy rate across all posting activities.
• Timeliness - Manual Posting: Complete within 2 business days of receipt.
• Timeliness - ERA Reconciliation: Complete within 5 business days of posting.
• Training Effectiveness: New hires achieve defined productivity and accuracy benchmarks within onboarding timelines.
• Process Optimization & SOP Compliance: SOPs remain current, consistently followed, and support audit and quality standards.

Qualifications

• Strong attention to detail.
• Advanced system knowledge.
• Ability to effectively train, coach, and standardize processes.