Healthcare Billing Specialist (RCM Operations – Dental Focused)
About the Company
We are a US-based healthcare technology company dedicated to helping healthcare providers optimize their Revenue Cycle Management (RCM) operations. Our team supports end-to-end billing processes, ensuring efficient claims management, accurate reimbursement, and operational excellence across healthcare organizations.
Position Overview
We are seeking an experienced Healthcare Billing Specialist to support high-volume US healthcare billing operations. The ideal candidate will have strong knowledge of the healthcare revenue cycle, including claims processing, accounts receivable follow-ups, denial management, and insurance verification.
This role requires exceptional attention to detail, strong communication skills, and the ability to work efficiently within a fast-paced environment while maintaining high levels of accuracy and compliance.
Key Responsibilities
Revenue Cycle Management- Process and manage medical billing activities for US healthcare accounts.
- Monitor and manage claims throughout the entire billing lifecycle.
- Ensure timely submission and resolution of claims.
- Conduct AR follow-ups and claim status investigations.
- Follow up on unpaid, delayed, denied, or rejected claims.
- Coordinate with insurance payers to secure timely reimbursement.
- Communicate with insurance companies through phone calls, payer portals, and other approved channels.
- Resolve claim discrepancies and payment-related concerns.
- Document all communications accurately and thoroughly.
- Review denied and rejected claims.
- Identify root causes of denials and implement corrective actions.
- Submit appeals and supporting documentation when required.
- Verify patient insurance eligibility and benefits.
- Review coverage details, authorizations, limitations, and co-pay requirements.
- Ensure accurate benefit information is documented in company systems.
- Maintain accurate and up-to-date records within PMS, EHR, and billing systems.
- Ensure data integrity and compliance with internal procedures.
- Meet established productivity, quality, and turnaround time targets.
- Follow company SOPs, billing guidelines, and compliance requirements.
- Participate in process improvement initiatives to enhance operational efficiency.
Qualifications
Required Qualifications- Minimum of 2–4 years of experience in US Healthcare Billing or Revenue Cycle Management (RCM).
- Strong knowledge of:
- Medical billing processes
- Claims lifecycle management
- Accounts Receivable (AR) follow-up
- Denial and rejection management
- Insurance payer processes
- Experience using payer portals and healthcare billing systems.
- Excellent English communication skills, both written and verbal.
- Strong analytical, problem-solving, and organizational skills.
- Ability to manage high-volume workloads while maintaining accuracy and quality.
- Strong attention to detail and commitment to compliance.
- Experience in Dental Billing and Dental RCM operations.
- Experience with Insurance Verification and Benefits Coordination.
- Familiarity with multiple Practice Management Systems (PMS) and Electronic Health Record (EHR) platforms.
- Ability to identify denial trends and recommend collection improvement strategies.
- Previous experience supporting US healthcare provider organizations.
Compliance and Work Environment
Employees in this role are expected to maintain strict compliance with healthcare industry regulations and company policies, including:
- HIPAA regulations and Protected Health Information (PHI) requirements.
- Data privacy, confidentiality, and information security standards.
- Client-specific operational and audit requirements.
- Secure work environment and access control procedures.
Compliance with all security, privacy, and operational policies is mandatory.
Compensation and Benefits- Competitive compensation package based on qualifications and experience.
- Performance-based incentives tied to productivity, quality, and operational performance.
- Career development and growth opportunities.
- Collaborative and professional work environment.
Join Our Team
If you have a strong background in US Healthcare Revenue Cycle Management and are looking to grow your career with a dynamic healthcare technology organization, we encourage you to apply.