Dental Revenue Cycle Specialist at Artisan Design Group, LLC

North Charleston, South Carolina, United States -

Full Time

Start Date

Immediate

Expiry Date

03 Jun, 26

Salary

25.0

Posted On

05 Mar, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Claims Submission, Payment Posting, Accounts Receivable Follow-Up, Payer Communication, Revenue Integrity, EOB Interpretation, Denial Management, Coding, HIPAA Compliance, Practice Management Software, Analytical Thinking, Problem-Solving, Coordination Of Benefits, Appeals Submission, Reconciliation

Industry

Description

Description Dental Revenue Cycle Specialist Job Type: Full-Time Location: Ladson, SC Position Summary The Dental Revenue Cycle Specialist plays a critical role in protecting and optimizing the financial performance of a multi-surgeon, multi-location oral surgery practice. This position is responsible for the accurate and timely management of claims submission, payment posting, accounts receivable follow-up, and payer communication to ensure maximum reimbursement and revenue integrity. This role requires strong attention to detail, analytical thinking, payer knowledge, and a proactive approach to resolving reimbursement barriers. The Revenue Cycle Specialist serves as a liaison between patients, providers, and insurance carriers to ensure accurate billing, regulatory compliance, and an exceptional patient financial experience. Key Responsibilities Revenue Integrity & Claims Management Review daily surgical schedules to ensure services are billed accurately and in accordance with documentation and payer requirements Prepare, scrub, and submit clean claims for medical and dental payers Ensure proper coding and claim set-up based on procedures, modifiers, and payer guidelines Monitor claim acceptance and resolve rejections promptly Payment Posting & Reconciliation Accurately post insurance and patient payments Review and interpret Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERAs) Identify contractual discrepancies and underpayments Reconcile payments against fee schedules and negotiated rates Accounts Receivable & Follow-Up Proactively work unpaid claims and aged accounts receivable Identify denial trends and root causes Submit timely appeals with appropriate documentation Follow through to resolution to ensure proper reimbursement Insurance & Payer Relations Communicate with insurance carriers to resolve claim issues and obtain clarification on benefits and processing Respond to payer requests for additional documentation in a timely manner Maintain working knowledge of commercial, Medicare, Medicaid, and leased network plans Understand coordination of benefits, medical vs. dental billing, and payer-specific requirements Patient Financial Support Respond to patient inquiries regarding billing and insurance processing Provide clear, professional communication regarding account balances and insurance activity Support a positive and transparent financial experience Data Accuracy & Compliance Enter and maintain accurate patient insurance demographics in practice management software Ensure compliance with HIPAA, OSHA, and internal policies Maintain required accuracy standards during account audits Adhere to all established and newly implemented RCM procedures Continuous Improvement & Collaboration Identify workflow improvement opportunities to reduce denials and increase collection efficiency Collaborate with insurance verification, front office, and clinical teams to resolve billing barriers Maintain professionalism in all telephonic and written communication Support departmental goals related to Days in AR, Net Collection Rate, and Denial Rate Requirements Qualifications Prior experience in dental or medical revenue cycle management required (oral surgery experience preferred) Strong understanding of EOB interpretation, claim lifecycle, and denial management Knowledge of dental and medical coding preferred Experience with multi-location or multi-provider environments a plus High attention to detail and ability to manage multiple priorities Strong communication and problem-solving skills Proficiency in practice management software systems Why This Role Matters Revenue Cycle is not simply posting payments, it is the financial backbone of the organization. The work performed in this role directly impacts practice growth, provider compensation, operational stability, and the patient experience. Expectations & Availability This role is on-site. Employees must attend meetings, trainings, and support on-site initiatives. Be responsive during working hours; notify supervisors of changes promptly. Key Metrics (KPIs & SLAs) Claim Submission: Within 48 hours of service. Payment Posting: Within 3 business days. AR less than 90 Days: Maintain at 10% or less. Denial Rate: less than 5% | Rejection Rate: less than 2% Appeals: Submitted within 5 business days. Refunds: Initiated within 2 days, processed in 7–10 days. Patient Inquiries: Respond within 24 hours. Internal/External Communication: Response required within 24 hours. Escalations: Billing errors unresolved after 48 hours must be escalated. Documentation: Same-day entries with proper attachments.

Responsibilities

The specialist manages the accurate and timely submission of claims, posting of payments, follow-up on accounts receivable, and communication with payers to maximize reimbursement for an oral surgery practice. Key duties include ensuring revenue integrity, resolving claim rejections, reconciling payments against fee schedules, and maintaining compliance with regulations.