RCM Insurance Specialist
About The Position
PepperPointe is looking for individuals who are excited by, and thrive in, an environment of impactful change. Our team spirit is evident every day, and we let our passions and creativity foster innovation. We take big swings, set ambitious goals, and challenge each other. If you are determined, solutions-oriented, collaborative, and committed to excellence, then we would love to have you join our organization as we work to make a positive impact in the communities we serve. We are looking for an RCM Specialist that will be responsible for performing duties related to Authorizations (Medicaid or other insurance), Claim Submission, Rejection follow-up, Payment Posting, Denial AR follow-up, and more. The RCM Specialist is the cornerstone in our RCM insurance billing operations, orchestrating a harmonious interplay of technical expertise, collaboration with the RCM teams and Practice Teams, client support, vendor management, problem-solving acumen, data integrity, and a commitment to continuous learning. Through these contributions, the RCM Specialist fortifies the foundation of our organization's success in insurance billing, payment posting, reconciliation, and follow up.
Requirements
- Dental insurance / billing experience is required.
- 1-2+ years dental insurance billing. Knowledge of dental terminology and effective dental revenue cycle management techniques.
- High School diploma or GED; some college coursework preferred.
- Proficiency in Microsoft Office (Excel, Word, Outlook, etc.) Google Drive a plus.
- Well-organized, clear communicator, diligent work ethic, and proficient computer skills.
- Multi-Tasker.
Responsibilities
- Understand the entire dental revenue cycle, ensuring timely and accurate RCM functions within the centralized team, in compliance with industry standards and organizational policies.
- Provide extensive knowledge of laws and regulations of dental coding and posting, and follow-up
- Understand and apply necessary and required adjustments taken on insurance payments.
- Efficient knowledge and implementation of coordination of benefits.
- Prepare and submit clean claims to insurance companies daily, minimizing any timely filing denials.
- Investigate and accurately resolve claim rejections promptly, reducing insurance ageing report numbers and simultaneously increasing insurance collections.
- Knowledge in proper account receivables, notation, and queueing of patient statements.
- Ability to read and understand Insurance Verification full breakdowns.
- Ability to complete and submit Prior Authorizations
- Understand the rules and regulations for Medicaid, Government, and commercial payers
- Utilize insurance payer websites, both from retrieving EFT payments, claim submission, and leveraging websites to maximize claim payments.
- Utilize clearinghouse knowledge to facilitate seamless data exchange.
- Maintain a high level of accuracy in payment posting, reconciliation, and insurance billing techniques and documentation.
- Meet deadlines consistently, ensuring timely completion of tasks.
- Collaborate effectively with internal teams, external partners and clients.
- Build and maintain positive relationships with payers, vendors, internal teams, to support the company's mission.
- Actively contributes to a collaborative and positive team environment.
- Demonstrate a growth mindset by seeking service opportunities for clients to support and provide a seamless revenue cycle management.
- Identify and address revenue cycle management challenges promptly and effectively.
- Work efficiently to implement processes and improve overall productivity.
- Foster a culture of engagement and open communication within the business unit.
- Collaborate with colleagues and direct managers to enhance workflow and communication.
- Provide exceptional service to clients and practices, addressing inquiries and concerns.
- Take accountability for the accuracy and integrity of client and patient data.
- Demonstrate the ability to quickly grasp and apply new concepts and industry updates.
- Stay informed about changes in dental billing and coding practices.
- Understand billing and regulations for General, Pediatric, Orthodontic and other specialties
- May be assigned in different specialties or areas
Benefits
- Medical, dental, and vision benefits
- 401K with company match
- A company culture of promotions from within, with a start-up atmosphere allowing for varied and rapid career development
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
11-50 employees
