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 practices

Proficiency 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 reporting

Technical & 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