Revenue Cycle Specialist—Full Cycle/Oral Surgery

Join

Max Surgical Specialty Management

, an innovative leader in the healthcare industry, as we embark on an exhilarating journey of growth and expansion!

We are seeking a motivated and dynamic individual to join our Revenue Cycle Management Team as a Revenue Cycle Specialist—Full Cycle.

What You'll Do:

• The Revenue Cycle Specialist—Full Cycle is responsible for the execution and management of the revenue cycle process from beginning to end for their assigned offices. As an Insurance Processor, you will be an integral part of the RCM team as well as each office you support. This role requires attention to detail as well as flexibility.
• The successful candidate will be able to: Review all patient insurance information needed to complete the billing, collections, appeal, and/or cash processes to ensure clean claims submission to insurance carriers
• Review all charges, coding and prepare for claims for electronic submission
• Work error reports from clearing house
• Obtain required attachments for claims submission from various EMR’s
• Resolve billing discrepancies and claim denials through follow-up with insurance companies
• Review and interpret dental EOBs (Explanation of Benefits), including patient deductibles, co-pays, and insurance/third-party correspondence
• Research and navigate insurance policies, benefits, and exclusions to provide accurate information to patients & management team
• Monitor outstanding claims and follow up with insurances to ensure timely payments
• Follow up to all third-party payers and self-pay accounts documenting appropriate information thoroughly on accounts
• Demonstrate a professional image in dealing with the public, patients, clinical offices, and insurance carriers
• Review credit-balance accounts on a weekly basis
• Submit corrected claims or appeals to insurances carrier for both Medical & Dental
• Perform appropriate adjustments, when required
• Gather payor trends and provide feedback to management
• Identify and resolve specific coding issues, providing feedback to management
• Work with internal revenue cycle and administrative teams to identify and manage 3rd party payor denials, overpayment, and underpayment issues
• Contact patients regarding coordination of benefits, insurance payments mailed to patient, and outstanding patient balance
• Communicate with leadership, patients, and insurance representatives to clarify billing discrepancies
• Communicate with healthcare providers, patients, and insurance representatives to clarify billing discrepancies
• Perform any and all other duties as assigned

What You’ll Bring:

• High School Diploma required, Medical Billing and/or Coding Certification highly preferred
• 3+ years of hands-on experience in healthcare revenue cycle management, with a proven track record of optimizing processes
• Proficient in all Microsoft Office applications as well as medical office software
• Proven experience in healthcare billing
• Sound knowledge of health insurance providers
• Strong interpersonal and organizational skills
• Excellent customer service skills
• The ability to work in a fast-paced environment

About MAX Surgical Specialty Management:

Established in September 2022 as the Northeast region’s first oral and maxillofacial surgery-only specialty platform, MAX Surgical Specialty Management is a surgeon-led management services organization developed with clinical and surgeon autonomy at its core. Today, MAX supports surgeons across New Jersey, New York, Pennsylvania, Vermont and Connecticut, enabling practices to channel resources, skills and knowledge within the oral surgery specialty, leading industry advancements and delivering the highest standard of patient care.

Surgeons have access to a curated network that allows them to collaborate with and work alongside a diverse pool of highly skilled peers who are leaders in their specialty. MAX safeguards surgeons’ independence while offering robust support systems, access to advanced technology and opportunities for financial growth.

Integrity-driven. Patient-focused. Experience the difference at www.max-ssm.com.