RCM Accounts Receivable Specialist

Company: Paradigm Oral Health
Location: Lincoln
Posted on: May 8, 2025

Job Description:

ROLE OVERVIEW The Accounts Receivables Specialist is responsible for managing 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 practicesProficiency 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 reportingTechnical & 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
                    
                    Compensation details: 24-28 Hourly Wage
                    
                    
                    
                    PI0dfedd6a1526-37248-37584443

Keywords: Paradigm Oral Health, Council Bluffs , RCM Accounts Receivable Specialist, Other , Lincoln, Iowa