Collections/RCM Specialist

Swish Dental•Austin, TX

1d•Onsite

About The Position

The Swish Dental team is looking for a highly motivated Collections/RCM Specialist to join our team onsite in Austin, TX. This role involves managing outstanding patient and insurance balances, following up on delinquent accounts, and overseeing various aspects of the revenue cycle process for the dental practice, including insurance verification, claims submission, payment posting, and accounts receivable follow-up. The specialist will utilize practice management software, collaborate with internal teams to optimize billing processes, and resolve denied, delayed, or underpaid claims.

Requirements

Minimum of 2 years of experience in dental collections and revenue cycle management.
Proficiency in dental billing software (e.g., OpenDental, Dentrix, Eaglesoft) and familiarity with dental coding (CPT, ICD-10).
Strong understanding of insurance billing processes and dental insurance plans.
Excellent written and verbal communication skills with the ability to explain complex information clearly and concisely.
Strong technical skills and/or quick learner.
Strong analytical and problem-solving skills to identify and address claim issues.
Meticulous attention to detail and accuracy.
Ability to prioritize tasks and work independently with minimal supervision.
Positive and patient demeanor to manage and resolve challenging situations.

Responsibilities

Monitor outstanding patient and insurance balances and follow up on delinquent accounts.
Contact patients by phone, email, text, and written communication regarding past-due balances.
Set up and monitor payment arrangements in accordance with company policies.
Process and document patient payments and account adjustments accurately.
Review accounts for outstanding insurance balances and coordinate with the billing/RCM team to resolve issues.
Identify and research discrepancies, denials, unapplied payments, and account credits.
Escalate complex or disputed accounts to the appropriate team member or manager.
Maintain accurate and detailed notes on all collection activities and patient communications.
Work assigned aging reports and prioritize accounts based on balance, age, and collection status.
Follow established collection procedures and applicable federal and state requirements.
Maintain patient confidentiality and comply with HIPAA requirements.
Communicate professionally and empathetically with patients regarding financial concerns.
Meet established collection, productivity, and quality metrics.
Provide reporting and updates on collection activity, aging trends, and outstanding balances.
Collaborate with Front Office, Billing, Insurance, and Revenue Cycle Management teams to improve collections and reduce aged receivables.
Identify recurring issues contributing to unpaid balances and recommend process improvements.
Assist with account cleanup, refunds, credit balances, and other AR-related tasks as assigned.
Review all aspects of the revenue cycle process for the dental practice, including insurance verification, claims submission, payment posting, and accounts receivable follow-up.
Utilize practice management software to enter data, prepare reports and ensure accuracy in entries.
Collaborate with our team to optimize billing processes and improve patient satisfaction.
Investigate and resolve denied, delayed, or underpaid claims.
Monitor and track accounts receivable aging to ensure timely collection and follow-up on overdue accounts.
Analyze claim denials and communicate root causes to the Swish team.
Research and gather missing information needed for claim processing.
Collaborate with dental providers and staff to gather necessary documentation and information for claims processing.
Handle appeals for denied claims, supporting providers with documentation and justification.
Track claim progress and proactively update the Swish team on status.
Maintain detailed records of all follow-up activities and claim outcomes.