RCM Specialist II - REMOTE

7d440142-9bea-47aa-bf93-d38fcb1973bd•Lincoln, NE

3d•$22 - $27•Remote

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 position requires a strong understanding of accounts receivable processes, account research, and payer guidelines, along with attention to detail and analytical skills in resolving account 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 accounts receivable follow-up, and payment posting.
Knowledge of reimbursement and compliance processes and procedures across payers.
Experience with practice management software, insurance portals, clearinghouses, insurance guidelines, and banking reconciliation software.
Intermediate PC skills, including strong Microsoft Excel skills, and strong computer literacy.
Excellent math and problem-solving skills.
Data-entry skills and ability to use a 10-key keypad by touch.
Strong interpersonal and organizational skills, with the ability to work both within a team and as an individual contributor.
Excellent oral and written communication skills.
Ability to produce quality work, meet deadlines, and follow 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 revenue cycle management activities in accordance with best practices and internal standard operating procedures.
Follow up on accounts receivable to resolve unpaid or underpaid claims, denials, and aged balances through appeals, corrections, resubmissions, or other appropriate actions.
Audit accounts to verify accurate claim submission, payment application, adjustments, and resolution of outstanding balances.
Review and resolve credit balances, and process refunds to insurance companies and patients 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 review accounts receivable aging reports to reduce days in accounts receivable and the percentage of accounts receivable over 90 days.
Document account activities, payer interactions, and refund processing thoroughly and clearly.
Collaborate with billing and front-office teams to support clean claims and quick resolution of issues.
Maintain compliance with HIPAA, payer guidelines, and internal policies.
Participate in team meetings covering performance metrics, workflow updates, and process improvements.
Support RCM management in identifying contributors to site-specific RCM KPIs and highlighting concerns and improvement opportunities.
Monitor and report on net collection rate performance against targets and collaborate with the team to identify improvement opportunities.
Track and evaluate average days in accounts receivable, investigate delays or bottlenecks, and support effective collections, payment application, claim filing, and claim resolution.
Review and analyze the percentage of accounts receivable over 90 days, distinguish insurance and patient balances, identify trends, and help reduce aged receivables.
Identify trends in rejections, disputes, payment delays, and denials; escalate issues and investigate root causes to prevent recurrence.
Maintain respectful and professional interactions with internal stakeholders, patients, payers, third parties, and others.