[Hiring] RCM Quality Specialist @Elite Dental Partners

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Role Description

The Revenue Cycle Quality Specialist is responsible for monitoring and analyzing dental practice adherence to revenue cycle related policies and processes. The role will audit, compile, and report on various Revenue Cycle and Operations related metrics.
• Monitor and audit practice compliance with Revenue Cycle policies and processes
• Review, question, and apply Miscellaneous Discretionary Credit Adjustments for specific Elite Dental Partner practice locations
• Review and post insurance refunds to practice location patient ledgers processed by Elite Dental Partners Accounts Payable Department on a weekly basis
• Pull, compile and report operational and quality metrics related to the Revenue Cycle and operational processes
• Investigate patient ledgers, as necessary, for accuracy and modify as required
• Ensure compliance with HIPAA and other relevant Federal and state regulatory requirements
• Complete and send Days to Claim Sent Report to operations on a weekly basis, usually by end of day on Friday
• Compile Unsent Claims data and reviews Credentialing holds and compares them to the Delta Toolkit
• Pulls guarantor payments for Dentrix Core and Dentrix Ascend for private pay analysis for month-end
• Assist with incomplete treatment reversals / adjustments as required
• Presents on Regional Manager and Office Manager Onboarding Calls on revenue cycle topics such as: SharePoint Requests, Adjustment Policy, EDP Employee and Family Discount, insurance refund process, reporting and special requests
• Provides end of year financial audit support and facilitates the pulling of patient ledgers for external audit sample completion

Qualifications
• Excellent communication skills, both written and verbal
• Ability to interact at all organizational levels
• Strong problem-solving skillset
• Self-starter who excels in a fast paced, data driven environment
• Must be proficient in MS Office tools

Requirements
• High School diploma or equivalent required; Associates degree preferred
• 3-5 years dental billing experience preferred with knowledge of claim submission process
• Strong Microsoft Excel skills required

Benefits
• Health Insurance: Medical, Dental, and Vision coverage
• Paid Time Off (PTO): Yes
• Retirement Plan: 401(k)

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