[Hiring] Revenue Cycle Specialist @Dental Care Alliance

Role Description

The Revenue Cycle Specialist, Payments & Remittance will be responsible for accurately posting and reconciling insurance payments into the practice management system, ensuring all transactions are recorded in compliance with contractual and regulatory guidelines. This role requires strong attention to detail, the ability to work across multiple systems, and a commitment to meeting accuracy and productivity benchmarks. This is a 100% remote position.

• Accurately post all insurance payments, adjustments, and denials to client accounts in an accurate and timely manner.
• Review and reconcile check deposits, EFTs, and lockbox reports to ensure completeness and accuracy of payment posting.
• Ensure all payments are posted in accordance with payer contracts and client-specific rules.
• Maintain a high level of productivity while meeting quality standards (99%+ accuracy).
• Ensure all payments show matched and reconciled on the Reconciliation Report, entering notes indicating reasoning for non-match on all discrepancies.
• Manage the Zentist portal daily to mark payments as posted and ensure the daily deposit is complete.
• Assign denied claims to denial management and AR teams within Denticon’s task manager to ensure proper handling of underpayments.
• Monitor and process Electronic Remittance Advice (ERA) in DentalxChange.
• Resolve all payments with missing Explanation of Benefits (EOB).
• Acquire Electronic Remittance Advice (ERA)/ Explanation of Benefits (EOB) files from multiple sources including but not limited to DentalxChange, Zentist, Payor Portals, phone calls to payors.
• Escalate recurring payer issues or payment variances to Revenue Cycle Manager for resolution.
• Maintain status reporting of workload on Daily Tracker for payment & denial posting, reconciliation and ERA processing for assigned practices.
• Pre-Audit and escalate fee discrepancies to the fees team.
• Initiates refund tickets of received overpayments requests from payors.
• Adhere to HIPAA guidelines and internal compliance protocols.

Qualifications

• High School Diploma or Equivalent Required.
• Associate’s Degree in Business Administration, Economics or related field strongly preferred.
• Three (3) years previous buying experience strongly preferred, or ability to demonstrate comparable combination of knowledge and skill.
• Ability to exercise independent judgement.
• Excellent written and verbal communication skills.
• Demonstrates aptitude in effective negotiating.
• Familiarity with market research, data analysis and forecasting techniques.

Requirements

• Productivity - Consistently post 30+ payments/adjustments per hour worked. Auto-posted payments are included in productivity totals.
• Accuracy - Maintain a minimum accuracy rate of 99% for all posting activities.
• Timeliness - Manual Posting: Ensure all manual payment postings are completed within 2 business days of receipt.
• Timeliness - ERA Reconciliation: Complete ERA auto-posting reconciliation within 5 business days of posting.

Company Description

The company is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, ancestry, color, age, national origin, ethnicity, religious creed or belief, physical or mental disability, marital or familial status, legally protected medical condition, genetic information, military or veteran status, sex, gender, sexual orientation, citizenship status, or any other characteristic protected by applicable law.