RCM Specialist I

Individual contributor role on the revenue cycle management team responsible for front-end and mid-cycle revenue cycle tasks, with a primary focus on insurance verification, claim submission, and customer service. The role supports accurate eligibility and benefit gathering across dental and medical payers, clean pre-authorization and claim generation, timely insurance processing, and a positive experience for patients and supported offices.

Responsibilities include verifying insurance coverage and benefits, updating insurance information in the practice management system, confirming eligibility and coordination of benefits, submitting pre-determinations and prior authorizations, preparing and submitting claims, reviewing and resubmitting rejected claims, responding to patient and office inquiries, assisting with patient statements and outstanding balances, documenting all work accurately, escalating issues as needed, maintaining HIPAA and payer compliance, and supporting broader revenue cycle functions and KPI monitoring.