RCM Account Receivables Specialist

Location: Tyler
Posted on: June 23, 2025

Job Description:

This is an in-person Monday-Friday position at our Tyler Oral & Facial Surgery Location at 805 Turtle Creek Dr, Tyler, TX 75701 www.tyleroralsurgery.com ROLE OVERVIEW The Accounts Receivables Specialist is responsible for managing dental and medical outstanding insurance balances, following up on unpaid claims, and reducing accounts receivable (AR) aging. KEY RESPONSIBILITIES - Follow up on claims over 30 days to ensure prompt resolution. - Investigate denied, delayed, or underpaid claims and appeal when appropriate. - Contact insurance payers to verify claim status and resolve payment delays. - Partner with the Billing, Payment Posting, and Pre-Authorization teams to streamline claim resolutions. - Identify trends in denials and non-payments and recommend process improvements. - Serve as a peer collaborator for new hires, helping them navigate AR processes. - Handle ad-hoc tasks and special projects assigned by management ESSENTIAL QUALIFICATIONS Prior experience in dental office revenue cycle functions, with expertise in: - Scheduling & Registration – Understanding patient flow and eligibility verification. - Insurance Verification – Confirming coverage, benefits, and policy limitations. - Fee Schedules & Charging/Coding – Ensuring accurate claim submission using CDT, CPT, and ICD-10 codes. - Claim Submission & Follow-Up – Knowledge of clean claim processing, payer-specific requirements, and handling rejections/denials. - Insurance AR & Payment Posting – Reconciling EOBs, applying payments correctly, and identifying underpayments. Strong knowledge of reimbursement & compliance processes for: - Medicare, Medicaid, PPO, HMO, and Fee-for-Service (FFS) plans - Payer guidelines, coordination of benefits (COB), and timely filing limits - Insurance dispute resolution and appeal submission best practices Proficiency in dental billing software & industry tools: - Practice Management Systems (PMS): CareStack, WinOMS, OMSVision, Dentrix, Eaglesoft, etc. - Insurance Portals & Clearinghouses: Working with Navinet, Availity, Change Healthcare, and payer-specific platforms - Banking Reconciliation Software: Matching deposits to payments for financial accuracy - Microsoft Office Suite: Strong Excel skills for data analysis and reporting Technical & Analytical Skills - Strong computer literacy with intermediate to advanced Excel proficiency (pivot tables, v-lookups, reporting). - Excellent math and problem-solving skills related to claim calculations and insurance adjustments. - Data entry expertise, including 10-key by touch, ensuring speed and accuracy in financial transactions. Soft Skills & Work Ethic - Strong interpersonal and organizational skills to work effectively within a team and independently. - Excellent oral and written communication skills, particularly in handling payer escalations and patient billing inquiries. - Demonstrates attention to detail, accuracy, and analytical thinking in identifying claim discrepancies. - Accountable for quality work, meeting deadlines, and adhering to RCM compliance and SOPs. What We Offer: - Core Benefits & Wellness - Comprehensive Medical, Dental & Vision Insurance (Virtual Care included) - Confidential Employee Assistance Program (EAP) for you and your family Financial Wellness - Competitive Pay with Bonus Opportunities & Annual Merit Increases - 401(k) Retirement Plan with Company Match - Health Savings Account (HSA) options with HDHP plans Life Insurance Protection - Company-Paid Basic Life Insurance - Optional Supplemental Life Coverage for You, Your Spouse & Children Time Away & Life Balance - Generous Paid Vacation (starting at 2 weeks!) 6 Paid Holidays - Short- and Long-Term Disability Coverage - Supportive Leave of Absence Options PI5d043878445d-37156-37929142

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