RCM Specialist II

Northern Nevada Oral Surgery; Reno (NV); On-site; USD 30,000 - 37,000; Full time

Job summary

Northern Nevada Oral Surgery seeks an experienced RCM Specialist II to support the revenue cycle, handle AR follow-up, posting payments, processing refunds, and auditing accounts. The role emphasizes accuracy, compliance, and improving KPI metrics within a dental practice environment.

The ideal candidate understands AR processes, payer guidelines, and is detail-oriented with strong analytical and communication skills.

Qualifications

• Prior experience in Dental Office workflows and Revenue Cycle functions including scheduling, registration, insurance verification, and claim submission.
• Knowledge of reimbursement/compliance with all payors.
• Proficient in MS Office; strong Excel skills; data entry and 10-key by touch.
• Excellent verbal and written communication; ability to work in a team or individually.
• Quality-focused with deadlines, compliance with Revenue Cycle SOPs.

Responsibilities

• Perform RCM activities per SOPs.
• AR follow-up to resolve unpaid or underpaid claims and denials.
• Audit accounts for accurate submission, payment posting, adjustments, and resolutions.
• Review and resolve credit balances; process refunds per policies.
• Post all payments accurately and timely, including remittance reconciliations.
• Apply adjustments and write-offs per payer contracts and guidelines.
• Monitor AR aging to reduce days in AR and AR over 90 days.
• Maintain thorough documentation of account activities and payer interactions.
• Collaborate with billing and front office to ensure clean claims and quick resolution.
• Ensure HIPAA compliance and adherence to policies.
• Participate in team meetings to discuss KPIs and process improvements.

Skills

Interpersonal skills

Analytical skills

Attention to detail

Communication skills

Time management

Team collaboration

Tools

Practice management software

MS Office

Insurance portals

Clearing houses

Bank reconciliation software

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

RCM Specialist II

2 days ago Requisition ID: 4473

Salary Range: $22.00 To $27.00 Hourly

ROLE OVERVIEW

The RCM Specialist II is an individual contributor role on the RCM team, responsible for AR follow-up, posting payments, processing refunds and credits, and auditing accounts accurately. This role supports the full revenue cycle, helping ensure timely resolution of outstanding balances, clean financial records, and a smooth experience for both practices and patients. An ideal candidate has a strong understanding of AR processes, account research, and payer guidelines. They are detail-oriented, analytical, and confident in navigating account-level discrepancies and improving key revenue cycle metrics.

KEY RESPONSIBILITIES

• Perform all assigned RCM activities in accordance with best practices and internal SOPs.
• Perform AR follow-up to resolve unpaid or underpaid claims, denials, and aged balances through appropriate action (i.e. appeals, corrections, resubmissions, etc.)
• Audit accounts to verify accurate claim submission, payment application, adjustments, and resolution of outstanding balances.
• Review and resolve credit balances; process refunds to insurance and patients in compliance with regulations and internal policies.
• Post all payments – insurance and patient – accurately and in a timely manner, including zero-dollar payments and remittance reconciliations (manual and electronic).
• Apply adjustments and write-offs appropriately based on payer contracts and internal guidelines.
• Work AR aging reports regularly to reduce days in AR and the percentage of AR over 90 days.
• Maintain clear and thorough documentation of account activities, payer interactions, and refund processing steps.
• Collaborate with internal teams (billing, front office) to ensure clean claims and quick resolution of issues.
• Maintain compliance with HIPAA, payer guidelines, and internal policies.
• Participate in team meetings to discuss performance metrics, workflow updates, and process improvements.
• Support RCM management in understanding and self-identifying contributing factors to site-specific RCM KPIs, highlighting areas of concern and areas for improvement. KPIs include but may not be limited to:
• Collection Rate: Monitor and report on the net collection rate, analyzing performance against targets. Collaborate with the team to identify opportunities for improvement.
• Days in AR: Track and evaluate average days in AR to ensure appropriate advanced collection, payment application, efficient and accurate claim filing, and timely back-end billing and claim resolution. Investigate and address any delays or bottlenecks that may be causing extended days in AR.
• % AR Over 90 Days: Review and analyze the percentage of AR over 90 days (insurance v. patient) to identify trends or issues requiring attention. Work with the team to reduce the percentage of aged receivables by implementing strategies to resolve outstanding claims and payments.
• Identify trends in rejections, disputes, payment delays, and denials, and escalation issues for resolution. Always seek the root cause to avoid future issues
• Maintain respect and professionalism in all interactions with internal stakeholders, patients, payers, third parties, and others

ESSENTIAL QUALIFICATIONS

• Prior experience in Dental Office workflows, Revenue Cycle functions to include Scheduling, Registration, Insurance verification, fee schedules, claim submission, charging/coding requirements, insurance AR follow up and payment posting process
• Must be knowledgeable of reimbursement/compliance process and procedures with all payors
• Experience with practice management software systems, insurance portals, clearing houses, insurance guidelines, banking reconciliation software, proficient in intermediate PC skills (MS Office—strong excel skills). Strong computer literacy, Excellent Math and problem-solving skills. Data entry and 10-key by touch.
• Strong interpersonal and organizational skills. Ability to work within a team setting and as an individual contributor. Excellent oral and written communication skills
• Responsible for quality work, meeting deadlines, and adherence to Compliance and Revenue cycle standard operating procedures
• Organized work habits, accuracy, and proven attention to detail with strong analytical skills
• Responsible for quality work, meeting deadlines, and adherence to Compliance and Revenue cycle standard operating procedures
• Certified Professional Coder (CPC) or Certified Revenue Cycle Professional (CRCP) credentials preferred