Revenue Cycle Management Specialist

NHOMS Payroll Services Inc•Nashua, NH

2d•$25 - $29•Onsite

About The Position

Join our innovative team at NHOMS | MassOMS and play an essential role in the financial health of our practice as we strive to create outstanding experiences for our patients, partners, and community. By embracing our core values of innovation, compassion, accessibility, and one team, you’ll be part of a team that makes a lasting impact on our organization’s growth and success. Our core values center around healing first for our patients. As a member of our team, we approach each day with compassion for both our patients and our team members. We promote innovation on every level, ensure we are accessible to one another, and work as one team. As NHOMS | MassOMS continues to stabilize and scale, we are strengthening our Revenue Cycle Management team by adding a Revenue Cycle Specialist. Collaborating with the RCM Manager, this role adds the production capacity needed to work claims and accounts receivable at the pace our multi-site volume requires. This position provides continuity and depth across core revenue cycle functions: reducing single-point dependency on any one team member while directly supporting the organization’s goals around clean claim rates, days in A/R, denial reduction, and a transparent, respectful patient billing experience. The Revenue Cycle Specialist is responsible for the day-to-day execution and health of the revenue cycle: verifying insurance, submitting clean claims, posting payments, reconciling deposits, working accounts receivable, and resolving patient billing questions. This is a hands-on production role that directly drives how quickly and accurately the practice is reimbursed. The role partners closely with the RCM Manager, who provides oversight, training, and escalation support; the Specialist owns the claims and accounts assigned to them and works within established productivity, accuracy, and A/R targets. The position also collaborates with clinical and front office teams across locations to resolve account discrepancies and support a smooth patient financial experience.

Requirements

Medical or dental billing experience: 1 year (required).
Demonstrated understanding of accounts receivable, insurance claim submission, and EOB reconciliation in a healthcare setting.
Strong communication, problem-solving, computer, phone, and analytical skills.
Ability to work efficiently within dental or medical practice management software systems.
Proficiency in Microsoft Office, including Excel and Word.
Strong attention to detail and comfort working with numbers and reconciliation.
Efficient time-management and prioritization skills, with the ability to work independently in a fast-changing environment.
Knowledge of laws and policies related to debt collection, and the judgment to apply them with professionalism.

Nice To Haves

Bachelor’s degree in Accounting, Finance, or a relevant field, or commensurate experience.
Dental, oral surgery, or related experience: 1 year.
Open Dental experience.
Multi-site or multi-state payer experience.
Experience with insurance follow-up and A/R management in a healthcare setting.
Working knowledge of medical, dental, and oral surgery terminology.
Familiarity with data collection and reporting, and presenting account or payer trends to leadership.

Responsibilities

Verify and update patient insurance coverage, eligibility, and benefits prior to services being rendered.
Communicate coverage limitations and patient financial responsibility to the appropriate clinical and front office teams.
Review claims for accuracy and completeness before submission, ensuring compliance with payer-specific guidelines.
Submit electronic and paper claims in a timely manner to support clean claim rate and days-to-bill targets.
Identify and correct billing and coding errors to reduce rejections and prevent avoidable denials.
Post insurance and patient payments to accounts accurately, reconciling EOBs and resolving discrepancies.
Reconcile EFT deposits within the bank account and escalate unresolved variances to the RCM Manager.
Balance out payments at the end of each day and complete daily payment reconciliation.
Support month-end financial reconciliation, ensuring payments and adjustments are accounted for.
Review and prioritize outstanding A/R, working aged claims according to established follow-up cadence.
Contact insurance companies to follow up on unpaid, underpaid, and denied claims, and take corrective action to resolve them.
Review patient A/R and make collection calls on outstanding accounts.
Research and resolve claim denials, coding discrepancies, and payment variances.
Escalate complex, high-dollar, or systemic payer issues to the RCM Manager with supporting documentation.
Track denial reasons and surface recurring patterns that indicate an upstream process or coding issue.
Initiate and track patient and insurance refunds through completion, in accordance with organizational policy and regulatory requirements.
Review credit balances and unapplied payments for timely resolution.
Respond to patient inquiries regarding billing statements, treatment estimates, payment options, and insurance coverage in a professional and empathetic manner.
Collect, post, and manage patient account payments and payment arrangements.
Coordinate with other departments to resolve patient account discrepancies and insurance issues.
Complete clerical revenue cycle functions including billing, treatment estimates, and monthly patient statements.
Maintain detailed and accurate documentation of all billing activities, payer communications, and account notes.
Ensure compliance with HIPAA, payer requirements, and company policies regarding patient information and billing procedures.
Audit assigned patient accounts for accurate billing, coding, and payment posting.
Stay current on changes to insurance policies, billing regulations, and compliance requirements.
Assist in the preparation of reports on claim status, payments received, and outstanding balances.
Provide accurate account-level detail to support the RCM Manager’s reporting on revenue performance and KPIs.
Assist other staff with billing and coding-related questions, and support training of new team members on billing processes and software as needed.
Participate in team meetings to review revenue cycle performance, surface trends and obstacles, and contribute to process improvements.