RCM Specialist II - REMOTE

Paradigm Oral Surgery; Lincoln (NE); Remote; USD 30,000 - 37,000; Full time

Job summary

Paradigm Oral Surgery is seeking an RCM Specialist II for a remote, full-time role. You will support the full revenue cycle, focusing on AR follow-up, posting payments, and auditing accounts to ensure clean financial records for practices and patients.

The ideal candidate has solid AR knowledge, attention to detail, and the ability to navigate discrepancies while improving KPI performance. This role requires strong communication and compliance with HIPAA and payer guidelines.

Qualifications

• Prior experience in Dental Office workflows and revenue cycle functions.
• Knowledge of reimbursement/compliance with all payors.
• Experience with practice management software, insurance portals, clearing houses.
• Strong PC skills with Excel; data entry and 10-key by touch.
• Excellent oral and written communication skills.
• Certified CPC or CRCP credentials preferred.

Responsibilities

• Perform all RCM activities following SOPs and best practices.
• AR follow-up to resolve unpaid/underpaid claims, denials and aged balances.
• Audit accounts to verify submission, payment application, adjustments and resolutions.
• Review and resolve credit balances; process refunds per regulations and policies.
• Post all payments accurately and timely, including zero-dollar payments and remittances.
• Maintain HIPAA compliance and collaboration with internal teams to ensure clean claims.

Skills

Interpersonal skills

Oral and written communication

Data entry

Excel skills

CPC/CRCP preferred

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 - REMOTE

Full Time Lincoln, NE, US

2 days ago Requisition ID: 4416

Salary Range: $22.00 To $27.00 Hourly

HOURS: M-F, 8-5

LOCATION: REMOTE

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 elevate 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