RCM Account Receivables Specialist Job at Tyler Oral & Facial Surgery, Tyler, TX

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  • Tyler Oral & Facial Surgery
  • Tyler, TX

Job Description

 

The Accounts Receivables Specialist is responsible for managing dental and medical 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

PI63a3aa5bbefa-30492-37929142

Job Tags

Holiday work, Full time, Temporary work, Remote job,

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