Revenue Cycle Specialist

Primary Responsibilities

• Resolve healthcare claims through verbal or online inquiries to health insurance payers.
• Effectively navigate and utilize various healthcare provider software systems.
• Verify patient, insurance, billing and claim submission information for accuracy.
• Eligibility inquiries and coordination of benefits research including reaching out to the patient when necessary.
• Research missing payments and secure documents needed for posting.
• Insurance claim billing: Work and manage claims from all aging buckets including posting and appeals.
• Coordination with offices to collect appropriate missing items for claim.
• Denial management: Investigates, and resolves denied claims in a timely manner.
• Appropriate adjustments: Pull EFT back-up (EOBs) as needed for claim resolution.
• Communicate with proper departments for any issues prohibiting proper allocation of payments to be posted.

Requirements

• 2+ years of multisite remote RCM support experience.
• Expert working knowledge of the RCM process and solutions, including how billing and coding impact financial revenue projections.
• Proficient with Microsoft Word and Excel.
• Comfort and flexibility working in a fast-paced health environment.
• Proven track record of customer service skills.

Expectations

• Maintain or improve collection rate benchmarks (e.g., >95% of net production).
• Keep claims denial rate below industry standard thresholds (e.g.,
• Reduce average days in A/R to target range (e.g.,
• Process 100% of claims within required billing timelines.
• Achieve timely resolution of outstanding or denied claims (e.g., within 30 days).
• Maintain high accuracy in payment posting and account reconciliation.

About Us

Specialty1 Partners is a practice services organization committed to providing non-clinical, business support services to the nation's leading specialty dental practices. The company was founded in 2019 by four endodontists who wanted to provide unique and differentiated support to specialty dental practices. Since its founding, Specialty1 Partners has grown rapidly to become one of the largest private owners of specialty dental practices in the US. Headquartered in Houston, TX, Specialty1 Partners is led by its founders and a management team that is focused on ongoing growth and delivery of best-in-class services across its network of practices. Specialty1 Partners currently has over 225 locations across 28 states.

Salary

$55,000 - $70,000 / per annum

Benefits

• BCBS Medical & Dental insurance Options
• VSP Vision Coverage
• Complimentary Life Insurance Policy (employee only)
• Short-term & Long-Term Disability
• Pet Insurance Coverage
• 401(k) plan w/match options
• HSA / FSA Account Access
• ID Theft Protection
• Legal Services Package
• Hospital/Accident/Critical Care Coverage
• Paid Time Off