RCM Specialist I - REMOTE

Location: REMOTE Hours: M-F, 8-5 The RCM Specialist I is an individual contributor role on the RCM team, responsible for front-end and mid-cycle revenue cycle tasks with a primary focus on insurance verification, claim submission, and customer service. This role ensures accurate eligibility and benefit gather across dental or medical payers, clean pre-authorization and claim generation, timely insurance processing, and a positive experience for patients and supported offices. The ideal candidate has a working knowledge of dental and medical billing processes, is detail-oriented, and is committed to delivering excellent service to both internal stakeholders and patients. KEY RESPONSIBILITIES Perform all assigned RCM activities in accordance with best practices and internal SOPs. Verify insurance coverage and benefits for scheduled patients using payer portals or phone calls. Accurately enter and update insurance information in the practice management system. Confirm eligibility, plan limitations, and coordination of benefits to ensure claims are submitted cleanly in the appropriate billing order. Submit pre-determination and pre-authorizations requested by the patient or supporting practices with all necessary clinical attachments, follow-up on processing status, and notify practice of status return in a timely manner ensuring treatment is not delayed. Prepare and submit claims (electronic, paper, or via portal) in accordance with payer-specific requirements and timelines. Rev