What are the responsibilities and job description for the Senior RCM Specialist position at Oral Surgery Partners?
Position: Senior RCM Specialist
Reports to: Senior Director, Revenue Cycle Management
Direct reports: None
FLSA status: Non-Exempt
Date: December 2024
Position Purpose
This role is responsible for conducting thorough audits of billing practices for new acquisitions, ensuring accuracy and compliance with industry standards. Additionally, this role will provide auxiliary billing support to offices requiring temporary assistance, ensuring smooth operations and effective management of oral surgery billing processes.
Essential Functions
Reports to: Senior Director, Revenue Cycle Management
Direct reports: None
FLSA status: Non-Exempt
Date: December 2024
Position Purpose
This role is responsible for conducting thorough audits of billing practices for new acquisitions, ensuring accuracy and compliance with industry standards. Additionally, this role will provide auxiliary billing support to offices requiring temporary assistance, ensuring smooth operations and effective management of oral surgery billing processes.
Essential Functions
- Billing Audits for New Acquisitions: Perform detailed audits of billing practices, coding accuracy, and insurance claim submissions for newly acquired dental offices. Identify discrepancies, inconsistencies, and areas for improvement to ensure seamless integration and compliance with ADA billing standards.
- Temporary Billing Support: Provide auxiliary billing support to various offices within our network. This may include filling in for short-term vacancies, assisting with complex billing issues, and ensuring the office maintains accurate billing processes during temporary staffing shortages.
- Insurance Verification & Coding: Verify insurance information, confirm patient benefits, and ensure accurate oral surgery codes (CPT, ICD-10) are used in billing and claims submissions. Address any coding issues to ensure proper reimbursement.
- Claim Management: Review and manage claims to ensure timely submission and follow-up. Work with insurance companies to resolve claim denials, rejections, and underpayments, ensuring optimal reimbursement.
- Documentation & Reporting: Maintain organized and accurate billing records. Generate reports on billing audits, claim statuses, and any findings to communicate effectively with management and the clinical team.
- Compliance & Training: Stay up to date on industry billing regulations, coding changes, and insurance requirements related to oral surgery. Assist in training office staff on billing processes, coding best practices, and compliance guidelines.
- Collaboration & Communication: Work closely with front office staff, dental providers, and management teams to resolve billing issues and ensure that billing and collections processes are aligned with organizational standards.
