Revenue Cycle Specialist – Oral Surgery

About Dental Oral Surgery

Dental Oral Surgery is one of the region's leading oral and maxillofacial surgery organizations, providing exceptional patient care across multiple locations. Our Revenue Cycle team plays a critical role in ensuring patients receive timely care while maintaining the financial health of our organization through accurate billing, insurance follow-up, and claims management.

We're looking for an organized, analytical, and detail-oriented Revenue Cycle Specialist who thrives in a fast-paced healthcare environment and enjoys solving complex insurance and billing challenges.

Position Summary

The Revenue Cycle Specialist is responsible for managing the complete lifecycle of oral surgery insurance claims—from clean claim submission through payment reconciliation, denial resolution, and appeals.

This position requires strong knowledge of medical and dental insurance billing, payer requirements, revenue cycle workflows, and claim resolution strategies. The ideal candidate is proactive, highly organized, and committed to maximizing reimbursement while maintaining regulatory compliance.

Primary Responsibilities

Claims Management

• Review claims for completeness and accuracy prior to submission.
• Submit electronic and paper insurance claims.
• Monitor claim acceptance and clearinghouse rejections.
• Correct rejected claims and resubmit promptly.
• Ensure timely filing requirements are consistently met.

Accounts Receivable Follow-Up

• Monitor outstanding insurance balances.
• Investigate delayed or unpaid claims.
• Contact commercial, Medicaid, Medicare, and managed care payers regarding claim status.
• Document all payer communications accurately.
• Escalate complex reimbursement issues when appropriate.

Denials & Appeals

• Analyze insurance denials and identify root causes.
• Prepare and submit reconsiderations, corrected claims, and formal appeals.
• Gather supporting documentation including clinical notes, radiographs, narratives, and operative reports.
• Track appeal outcomes and identify denial trends.
• Collaborate with clinical and administrative teams to reduce recurring denials.

Payment Posting & Reconciliation

• Verify insurance payments against contracted reimbursement.
• Identify underpayments and payment variances.
• Assist with reconciliation of outstanding claims.
• Research unapplied payments and payer discrepancies.
• Support monthly revenue cycle reconciliation activities.

Revenue Cycle Performance

• Maintain assigned AR inventory and productivity standards.
• Work aging reports to reduce outstanding receivables.
• Assist with identifying workflow improvements.
• Maintain compliance with HIPAA and payer regulations.
• Participate in departmental quality improvement initiatives.

Qualifications

Required

• 2 years of healthcare revenue cycle, medical billing, or dental billing experience.
• Experience with insurance claims submission and follow-up.
• Knowledge of commercial insurance, Medicaid, Medicare, and managed care plans.
• Strong understanding of CPT, CDT, ICD-10, and insurance billing practices.
• Excellent analytical and problem-solving skills.
• Strong written and verbal communication.
• Exceptional attention to detail.
• Ability to manage multiple priorities in a fast-paced environment.
• Proficiency with Microsoft Office, particularly Excel.

Preferred

• Experience in Oral Surgery, OMS, Dental Specialty, Ambulatory Surgery, or Surgical Billing.
• Experience using Dentrix Ascend or similar practice management software.
• Knowledge of medical necessity documentation.
• Experience preparing insurance appeals.
• Understanding of payer contracts and reimbursement methodologies.
• Familiarity with electronic clearinghouses.

Ideal Candidate

You are someone who:

• Takes ownership of your work.
• Enjoys solving difficult reimbursement problems.
• Has exceptional attention to detail.
• Can communicate professionally with insurance representatives.
• Works well independently while contributing to a collaborative team.
• Continuously looks for ways to improve processes and reduce denials.

Success in This Role

Within your first six months, you will be expected to:

• Consistently submit clean claims with minimal errors.
• Maintain assigned accounts receivable within departmental targets.
• Resolve denials efficiently and maximize reimbursement.
• Accurately reconcile insurance payments.
• Identify opportunities to improve revenue cycle performance.
• Contribute positively to a collaborative, high-performing Revenue Cycle team.

Why Join Dental Oral Surgery?

At Dental Oral Surgery, you'll be part of an organization focused on operational excellence, continuous improvement, and exceptional patient care. We invest in our employees by providing opportunities for professional development, process improvement initiatives, and advancement within a growing healthcare organization.

Pay: $21.78 - $27.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Health insurance
• Health savings account
• Paid time off

Work Location: In person

Salary : $22 - $27