Revenue Cycle Claims Specialist

D4C Dental Brands is seeking a Revenue Cycle Specialist

JOB SUMMARY:

The Revenue Cycle Specialist for understanding the entire revenue cycle process from claims submission to the final payment of the claim. This includes billing, collections, and ensuring compliance with regulations. They are also responsible for creating and maintaining standard operating procedures (SOPs) for billing and collections, training staff on revenue cycle processes, and addressing payer-related issues to optimize reimbursement. The specialist will collaborate with clinical staff, insurance companies, and patients to enhance revenue capture, minimize discrepancies, and ensure smooth financial operation.

MAJOR RESPONSIBILITES AND DUTIES

Receive and audit all payer-related issues from the RCM team and validate for accuracy.

1. Work with Credentialing team to resolve any payer issues.
2. Stay current with updates that are hindering payer related issues.
3. Understanding all departmental processes.
4. Creating and maintaining Standard Operating Procedures.
5. Train staff in revenue cycle processes
6. Creating reports as directed by management
7. Provide support for RCM team as directed by management

QUALIFICATIONS & SKILLS

• Bachelor's degree in finance, Accounting, or a related field preferred or
• 5+ years of experience in accounts receivable, with at least 2 years in a managerial role.
• Experience in the dental industry is a plus.
• Proficiency in Microsoft Excel.
• Strong analytical and problem-solving skills.
• Excellent communication and interpersonal skills.

• Ability to make independent decisions through detailed analysis and review

• Ability to maintain professionalism in difficult and stressful situations with a positive attitude
• Ability to work independently while handling multiple projects and tasks concurrently and timely.

D4C Dental Brands is seeking a Revenue Cycle Specialist

The Revenue Cycle Specialist will assist the Revenue Cycle Department with support of practice management, revenue cycle and data support for D4C. This role will interface with multiple departments within D4C. This role is fast paced and has a high degree of responsibility and accountability. It is a key component to executing on the company's growth strategy. In addition, the Revenue Cycle Specialist will assist with projects surrounding the growth of the company.
Education/Credentials:
* Bachelor's degree in Business Administration, Accounting or Finance required.
Job Related Experience:
* 1 -2 years in reporting and analysis required
Job-Related Skills/Competencies:
* Adhere to all compliance guidelines and regulations as established by D4C Dental Brands, Inc.
* Strong analytical and problem-solving skills.
* Expert with Microsoft Excel.
* Strong attention to detail and commitment to ensuring accuracy.
* Must be a self-starter with a positive attitude.
* Ability to work independently and make independent decisions through detailed analysis.
* Willingness and ability to manage multiple projects and meet deadlines
* Want to understand the business and how it builds
* Identifying opportunities to automate manual processes, reduce costs and to improve and streamline processes for greater efficiency and cost savings.
* Ad hoc projects and other duties as assigned.
* Serve as backup to RCM team members as needed.
* Knowledge and understanding of different insurance plans, including Medicaid
* Assist in any special projects as requested
* Provide management with weekly issues log identifying issues hindering collections by payer.

Major Duties and Responsibilities:
* Collect, organize, and maintain data.
* Assist in building and automating new and existing reports.
* Work to perform root cause analyses, standard timely reporting, as well as ad hoc reports.
* Work to improve interdepartmental reporting.
* Communicates and collaborates effectively at all levels across the organization. Performs other duties, as assigned.