Dental Revenue Cycle Specialist Job New York New York USA,Insurance

Revenue Cycle Specialist – Dental

We are seeking an experienced and highly knowledgeable Revenue Cycle Specialist to take ownership of insurance-related functions across our dental practice.

This individual will be our go-to expert for all things insurance and will be responsible for ensuring claims are submitted accurately and promptly, payments are properly posted, outstanding claims are aggressively followed up on, patient ledgers remain accurate, and insurance revenue is collected efficiently.

The ideal candidate has an exceptional understanding of dental insurance and revenue cycle management and is someone who doesn't simply process claims—they identify problems, investigate discrepancies, follow through to resolution, and make sure revenue does not fall through the cracks.

Key Responsibilities

Billing & Claims Management

Review and batch procedures for accurate and timely insurance billing.
Submit clean claims with appropriate documentation, narratives, attachments, and supporting information.
Verify coding and claim information prior to submission.
Monitor claim status and follow up consistently on unpaid, delayed, rejected, or denied claims.
Research denials and take appropriate action to correct and resubmit claims.
File appeals and provide additional documentation when necessary.
Identify recurring claim issues and implement solutions to prevent future delays or denials.
Maintain an organized system for tracking outstanding insurance claims.

Insurance Accounts Receivable

Actively manage insurance A/R and work aging reports.
Follow up with carriers on outstanding balances.
Identify claims that require immediate attention and prioritize collection efforts.
Research underpayments, incorrect payments, denials, and other discrepancies.
Ensure insurance balances are resolved appropriately and in a timely manner.
Identify trends affecting collections and communicate concerns to management.

Payment Posting & Reconciliation

Accurately post insurance payments, adjustments, and write-offs.
Review EOBs and electronic remittance information for accuracy.
Ensure payments are allocated to the appropriate procedures and patient accounts.
Research discrepancies between expected and actual insurance payments.
Identify incorrect adjustments or contractual write-offs.
Reconcile insurance payments and ensure accounts are properly balanced.

Patient Ledger Management

Review and maintain accurate patient account ledgers.
Identify incorrect balances, unapplied payments, credits, adjustments, or insurance allocations.
Research and correct ledger discrepancies.
Coordinate insurance and patient balances to ensure patients are billed appropriately.
Assist with complex account questions and insurance-related patient inquiries.

Credentialing & Insurance Administration

Manage provider credentialing and recredentialing with insurance carriers.
Maintain accurate records of provider participation and credentialing status.
Track credentialing applications and follow up with carriers until completion.
Maintain current provider and practice information with insurance companies.
Assist with adding or removing providers and locations from insurance plans as necessary.
Handle insurance-related administrative projects and carrier communications.

Insurance Expertise

This position requires someone who can serve as an internal insurance resource for the practice
.

The Revenue Cycle Specialist should have a strong understanding of:

Dental insurance benefits and terminology
PPO plans and fee schedules
In-network and out-of-network benefits
Deductibles, maximums, co-insurance, and frequency limitations
Coordination of benefits
Claim submission requirements
EOBs and electronic remittances
Claim denials and appeals
Insurance aging and accounts receivable
Contractual…