What are the responsibilities and job description for the Dental RCM Specialist position at C&TDG Management LLC?
We are a growing dental service organization (DSO) that supports several dozen partner locations across the country. Our goal is to help you grow and positively impact lives by improving the smiles, confidence, and overall health of our guests.
We are looking for a team member with dental billing and accounts receivable experience to join our RCM team. Preferred experience with Dentrix, Denticon, or Eaglesoft software. This person will be a full-time, goal-oriented, disciplined, revenue-driven, highly accurate and motivated coordinator.
General Responsibilities
- Review each claim for assigned offices for accuracy of provider of service, claim billing address, dental code utilized as reflected in clinical notes and proper patient and subscriber information.
- Identify procedures that need attachments (x-rays and narratives). Make sure all required attachments are attached as required before claim is sent.
- Ensure all claims are sent within twenty-four (24) hours of date of service.
- Responsible for all claims for assigned offices to be resolved within thirty days.
- Research, track, and document in a clear and concise manner claim status and reasons for any delay in claim adjudication.
- Analyze and interpret existing file notes and coverage documentation to competently respond to claim rejections or requests for additional information.
- Handling of difficult or non-routine claims and adjustment projects by partnering with RCM team and Support Center Staff.
- Analysis, tracking and trending of claim issues and payor payment cycles to improve internal processes.
- Following up on dental billing and accounts receivable for all payer types
- Processing dental insurance EOBs, appeals, denials, and following up with denial resolutions appropriately
- Ensuring claim submissions for secondary coverage is within timely filing limits
- Ensuring responses to claim inquiries and tracing is within timely filing limits
- Conducting complete patient account audits to determine appropriate action
Skills and Attributes Required
- Knowledge of Dentrix, Denticon and Eaglesoft PMS systems
- Must be able to read both pediatric and adult x-rays.
- Microsoft Excel Creation and basic functional working knowledge
- Revenue Cycle Focused; Ability to understand how revenue flows into and out of an organization
- High attention to detail and accuracy
- Ability to meet set productivity expectations.
- Demonstrate excellent decision making, analytical, and problem-solving skills.
- Ability to work independently and in a team setting.
- Must have good time management and customer service skills.
- Maintain strict compliance with State, Federal, and other regulations HIPAA, OSHA, and ADA
Education and Experience Requirements
- High school diploma or equivalent
- Minimum 2 years of dental experience
- Preferred experience of dental claims billing
- Previous clinical experience in the dental field is a plus!
