Senior Revenue Cycle Analyst

2 weeks ago

Lincoln, Nebraska, United States Paradigm Oral Health Full time

Key Responsibilities

The Revenue Cycle Specialist is proficient and cross-trained in all facets of the revenue cycle, thriving in a fast-paced environment. The primary responsibilities include:

  • Executing both manual and electronic posting tasks for all payors and patient accounts, ensuring accurate cash balancing and bank deposit reconciliation.
  • Processing payment adjustments, transfers, and handling non-sufficient funds (NSF).
  • Investigating and resolving unapplied accounts through established identification methods.
  • Analyzing and rectifying discrepancies in insurance accounts receivable and payment posting ledgers.
  • Reviewing patient accounts to identify and correct discrepancies, conducting account audits, managing aging accounts receivable, and resolving credit balances and unposted payments.
  • Ensuring ledger accuracy and maintaining account integrity.
  • Conducting thorough research on payor recoupments, identifying errors, and disputing claims to recover lost revenue. Validating patient refunds before processing them.
  • Maintaining up-to-date knowledge of insurance rejection and denial processes, accurately posting information for collection and follow-up.
  • Researching and responding to all correspondence related to assigned accounts, including explanation of benefits (EOBs) and documentation letters, and generating requests for necessary information.
  • Managing all aspects of follow-up and collections, including making calls and accessing payer websites, while identifying trends and providing resolution suggestions.
  • Documenting all pertinent collection activities thoroughly and accurately. Reviewing account information to determine the next appropriate action.
  • Investigating and resolving claims that have been denied or rejected by insurance.
  • Initiating appeals and ensuring all required documentation is submitted during the appeal process. Conducting follow-ups on all denials as necessary.
  • Verifying claims adjudication using appropriate resources and applications.
  • Handling inbound and outbound calls to/from insurance companies and patients to collect outstanding payments.
  • Addressing patient billing inquiries and serving as a resource for billing-related questions.
  • Contacting patients via phone or letter to gather additional information as needed.
  • Verifying insurance benefits through various methods, including websites, fax, and phone, while understanding plan types and configurations.
  • Performing essential billing functions, including manual re-bills and electronic submissions to payers, ensuring compliance with billing guidelines.
  • Processing clean dental claims for payment from all insurance companies to guarantee timely coding, billing, and collections.
  • Managing and prioritizing assigned workloads, completing reports, and addressing high-priority and aged inventory.
  • Meeting goals and objectives in designated areas of revenue cycle operations.
  • Identifying issues or areas for improvement within own responsibilities and developing resourceful solutions.
  • Other duties as assigned by leadership.
Qualifications and Education Requirements
  • Experience in dental office workflows and revenue cycle functions, including scheduling, registration, insurance verification, fee schedules, claim submission, coding requirements, and payment posting processes.
  • Knowledgeable about reimbursement and compliance processes with all payors.
  • Familiarity with practice management software, insurance portals, clearinghouses, and banking reconciliation software, along with strong proficiency in MS Office, particularly Excel.
  • Excellent interpersonal and organizational skills, with the ability to work collaboratively and independently.
  • Strong oral and written communication skills, with a commitment to quality work and adherence to compliance standards.
  • Demonstrated attention to detail, accuracy, and strong analytical skills.

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