Revenue Cycle Specialist
Madison, WI
Full Time
Cherry Tree Dental
Experienced
Revenue Cycle Specialist (Full-Time, Non-Exempt)
Cherry Tree Dental | Madison, WI
Remote with occasional travel
Cherry Tree Dental is seeking a detailed-oriented and results-driven Revenue Cycle Specialist to join our team. This role plays a critical part in supporting efficient clinic operations by ensuring accurate patient and insurance information prior to treatment and managing full revenue cycle to optimize reimbursement and cash flow.
**While this role will primarily be remote, it will require occasional travel to Cherry Tree Dental clinical sites, work locations, and schools, therefore candidates should be within a reasonable distance of Madison, WI.**
Key Responsibilities:
Insurance Verification
- Verify patient insurance eligibility and benefits prior to scheduled appointments.
- Review and confirm coverage details, including annual maximums, deductibles, frequency limitations, waiting periods, and coordination of benefits.
- Accurately document verified insurance benefits in the practice management system to ensure reliable financial and clinical workflows.
- Create, update, and maintain accurate insurance plans within the practice management system.
- Ensure patient plans contain correct payer information, group and policy numbers, and coverage details.
- Conduct routine audits of insurance plans to identify inaccuracies and remove outdated or duplicate records.
- Submit insurance claims daily in a timely and accurate manner.
- Manage payor portals and regularly retrieve EFTs and ERAs from insurance websites.
- Post insurance payments and contractual adjustments accurately to patient ledgers.
- Perform consistent follow-up on aged insurance claims to ensure proper reimbursement.
- Forward aged accounts to collections as appropriate and post payments received from collection agencies.
- Assist with identifying, processing, and reconciling patient refunds.
- Review clinic schedules to confirm insurance eligibility and benefits prior to patient visits.
- Collaborate with clinic teams to resolve insurance discrepancies before treatment is rendered.
- Support the development of accurate treatment estimates based on verified insurance benefits.
- Proactively identify insurance setup or eligibility issues that may result in claim denials.
- Partner with billing and accounts receivable teams to correct systemic insurance configuration issues.
- Track and analyze denial trends related to eligibility, benefit verification, or plan setup errors.
- Work closely with office managers and clinic teams to improve insurance verification and billing workflows.
- Provide guidance and training on proper insurance data entry and verification procedures.
- Communicate common insurance challenges that may impact patient billing and collections.
- Identify trends in insurance errors, eligibility issues, and claim denials that affect revenue performance.
- Recommend process and workflow improvements to enhance overall revenue cycle effectiveness.
- Participate in ongoing Revenue Cycle Management (RCM) optimization initiatives.
What We’re Looking For:
- High school diploma or equivalent
- Associate’s degree in healthcare administration, business, or related field preferred
- Two (2) years of experience in dental or healthcare revenue cycle management.
- Proficient or the ability to become proficient within 90 days in dental software.
- Strong understanding of dental insurance verification and benefit structures
- Knowledge of claims submission and insurance billing processes.
- Strong attention to detail and critical thinking skills.
- Knowledge of insurance denial management and accounts receivable follow-up preferred.
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