Rcm Specialist Ortho

Position Title: RCM Specialist

Description:

Specialty Dental Brands (SDB) is a leading dental service organization focused on partnering with the best doctors with a proven record of accomplishment of patient care and community involvement. We provide proven operational support, technology, and overall practice management across a nation-wide network of leading class pediatric dentistry, orthodontics, and oral surgery platforms. We are looking for a talented and highly motivated individual who has a natural desire to improve and build new processes and thrive in a start-up culture and rapidly growing business.

RCM Specialists are primarily responsible for supporting RCM functions of the front and back office through training, education, analyzing collections, resolving non-payables special projects, handling inquiries for complex revenue cycle issues, front office auditing, clearing house management, and assistance on any special projects assigned.

Job Type:

· Full-Time

· Hybrid (after onboarding period)

· May require up to 50-75% Travel depending on the need of the practice or region.

· Based in the region you will directly support.

Responsibilities:

· RCM specialists will be responsible for the assigned region's net revenue percentage to ensure the practices increase revenue and decrease RCM errors.

· RCM processes, policies, and compliance items are followed by working with the Regional Directors and RCM Director.

· SME for the Revenue Cycle process and communicate, educate, and train front and back-office RCM processes.

· SME knowledge of billing, coding, and productivity auditing

· SME knowledge of payer processing and payer policies, Medicaid, and Dental Payers, sometimes medical payers.

· Possesses the ability to work in a constantly changing environment, good judgment skills, and capable of making decisions with attention to detail.

· Must have excellent organizational skills and ability to prioritize and coordinate workload with high proficiency and accuracy.

· Must have excellent analytical and problem-solving skills.

· Maintains strict confidentiality of patient’s medical records and adherence to all HIPAA and ACHC policies and regulations.

· Must be extremely accurate with attention to details, policies, and procedures.

· SME knowledge of billing, coding, and productivity auditing

· Ability to report trending data and identify areas of RCM opportunities.

· Must develop and update multiple Action Plans and produce positive revenue outcomes.

· Must be agile to move from project to project at a quick pass or be able to change gears quickly.

· Meet established production and quality standards as set by Specialty Dental Brands

· Excellent and accurate calculator and computer skills. Including the ability to use Microsoft Excel, Microsoft Word, E-Mail. Excel and Data will be a major function of the job; therefore, you must be able to work with Excel functions and pivot tables.

· Performs special projects and other duties as assigned.

· Immediate to High-level knowledge of medical and dental billing rules, such as coordination of benefits, modifiers, Medicare, and Medicaid, and understanding EOBs.

· Strong oral, written, and interpersonal communication skills

Strong time management and organizational skills

· Strong knowledge of Outlook, Word, Excel (pivot tables), and database software skills

· Ability to read, understand, and apply state/federal laws, regulations, and policies.

· Ability to adapt to and train on multiple PM systems.

· Ability to communicate with diverse personalities discreetly, maturely, and professionally.

· Ability to remain flexible and work within a collaborative and fast-paced environment.

· Ability to work easily and cooperatively with other departments.

· Ability to work independently and follow through on tasks without direct supervision.

· Ability to work well under pressure in a flexible, diplomatic, and expeditious manner.

· Ability to work with all levels of teams, Entry-level to Sr. Leadership

Organizational Alignment:

· Reports to: RCM Director

· Other Key Relationships: General Manager, VP of Revenue Cycle

Required Minimum Qualifications:

· High School Diploma or GED

· At least five (5) years in the healthcare or dental RCM functions.

· At least five (5) years in billing and claims resolution

· At least five (5) years of dental front office RCM functions

· Preferred: CPB (Certified Professional Biller), CMB (Certified Medical Biller), CDC (Certified Dental Coder), CDBS (Certified Dental Billing Specialist). Must be willing to obtain certification if asked.