RCM Specialist II

7d440142-9bea-47aa-bf93-d38fcb1973bd•Reno, NV

3d•$22 - $27

About The Position

The RCM Specialist II is an individual contributor on the revenue cycle management team. The role supports the full revenue cycle through accounts receivable follow-up, payment posting, refund and credit processing, and account audits. The Specialist helps resolve outstanding balances, maintain accurate financial records, and support a smooth experience for practices and patients. The role requires a strong understanding of AR processes, account research, and payer guidelines, as well as attention to detail, analytical ability, and confidence investigating account-level discrepancies and improving revenue cycle metrics.

Requirements

Prior experience with dental office workflows and revenue cycle functions, including scheduling, registration, insurance verification, fee schedules, claim submission, charging and coding requirements, insurance AR follow-up, and payment posting.
Knowledge of reimbursement and compliance processes and procedures for all payors.
Experience with practice management software systems, insurance portals, clearinghouses, insurance guidelines, and banking reconciliation software.
Intermediate PC skills, including strong Excel skills, and strong computer literacy.
Excellent math and problem-solving skills; data entry and 10-key by touch.
Strong interpersonal and organizational skills, with the ability to work both in a team setting and as an individual contributor.
Excellent oral and written communication skills.
Ability to produce quality work, meet deadlines, and adhere to compliance and revenue cycle standard operating procedures.
Organized work habits, accuracy, attention to detail, and strong analytical skills.

Nice To Haves

Certified Professional Coder (CPC) credential.
Certified Revenue Cycle Professional (CRCP) credential.

Responsibilities

Perform assigned RCM activities in accordance with best practices and internal standard operating procedures.
Follow up on unpaid or underpaid claims, denials, and aged balances, taking appropriate action such as appeals, corrections, and resubmissions.
Audit accounts to verify accurate claim submission, payment application, adjustments, and resolution of outstanding balances.
Review and resolve credit balances and process insurance and patient refunds in compliance with regulations and internal policies.
Post insurance and patient payments accurately and promptly, including zero-dollar payments and manual and electronic remittance reconciliations.
Apply adjustments and write-offs according to payer contracts and internal guidelines.
Regularly work AR aging reports to reduce days in AR and the percentage of AR over 90 days.
Document account activities, payer interactions, and refund processing steps clearly and thoroughly.
Collaborate with billing and front office teams to support clean claims and timely issue resolution.
Maintain compliance with HIPAA, payer guidelines, and internal policies.
Participate in team meetings about performance metrics, workflow updates, and process improvements.
Support RCM management in understanding site-specific RCM KPIs and identifying contributing factors, concerns, and opportunities for improvement.
Monitor and report net collection rate performance against targets and collaborate on improvement opportunities.
Track and evaluate days in AR, investigate delays or bottlenecks, and support efficient claim filing, payment application, collection, and claim resolution.
Review and analyze AR over 90 days by insurance and patient balances, identify trends, and work with the team to reduce aged receivables.
Identify trends in rejections, disputes, payment delays, and denials, escalate issues, and seek root causes to prevent recurrence.
Maintain respectful and professional interactions with internal stakeholders, patients, payers, third parties, and others.