RCM Billing Specialist

Claims Management & Billing Specialist The Claims Management & Billing Specialist plays a key role in supporting all operational aspects of the revenue cycle for the Emerge program. This position will perform front-end and back-end billing processes, including claims management, payment posting, insurance follow-up, and patient financial communication. The Specialist ensures accurate and timely handling of billing functions to maintain strong cash flow and patient satisfaction. Responsibilities Submit accurate claims to insurance payers in accordance with established timelines. Review and resolve claim rejections and denials. Post insurance and patient payments, adjustments, and refunds. Verify patient eligibility and benefits; obtain and track pre-authorizations when required. Perform insurance accounts receivable (A/R) follow-up to resolve outstanding claims. Respond to patient inquiries related to billing, payments, and account balances. Support financial transparency by reviewing patient ledgers and providing clear explanations. Collaborate with clinical and front office teams to ensure complete and accurate documentation. Support other projects as assigned by leadership. Qualifications Minimum Qualifications 3+ years of experience w/High School Additional Experience 5+ years of experience in dental or medical revenue cycle, claims and/or billing roles preferred Knowledge, Skills, Abilities Strong knowledge of claims billing, EOBs, payment posting, and A/R follow-up. Knowledge of and ability to use eligibility tools and payer portals. Excellent customer service skills. Superb verbal, written and interpersonal communication skills. Excellent time management and organization skills. Familiarity with electronic health records (EHR) and practice management systems such as Epic, Dentrix, Eaglesoft, Denticon, Dental Xchange, etc. Base Pay Information The national base pay range at the end is a good-faith estimate of what Delta Dental may pay for new hires. Actual pay may vary based on Delta Dental's assessment of the candidate's knowledge, skills, abilities (KSAs), related experience, education, certifications and ability to meet required minimum job qualifications. Other factors impacting pay include prevailing wages in the work location and internal equity. Pay Grade 15. $40,500 - $84,800 Additional Information Behind the smile! We are dedicated to safeguarding the health and financial stability of our employees and their loved ones. This commitment extends beyond the workplace to foster personal growth and holistic wellbeing. Our life-changing rewards package includes: Competitive base and incentive pay 401(k) with robust matching and non-matching contributions Rich medical & pharmacy benefits 100% employer-paid dental and vision benefits Holistic wellbeing program with deep financial incentives Generous paid time off plus 12 paid holidays and your birthday off Culture of growth and learning: career development; tuition reimbursement; recognition program Family support: adoption assistance, fertility treatment, child, elder & pet care assistance Social responsibility and volunteer opportunities Employee discount program Fair Chance Ordinances and Criminal Background Considerations This position requires that the applicant undergo a background check. Qualified applicants with arrest or conviction records will be considered for employment in accordance with any applicable federal, state or local laws, including, but not limited to, the California Fair Chance Act, the Los Angeles County Fair Chance Ordinance, the City of Los Angeles Fair Chance Initiative for Hiring Ordinance, the San Francisco Fair Chance Ordinance, and/or New York Corrections Law Article 23-A. About the Team Delta Dental Ins. is an equal opportunity employer and is committed to providing a professional work environment free from discrimination and harassment. Individuals seeking employment at Delta Dental are considered without regard to race, ethnicity, color, age, sex, religion, national origin, ancestry, pregnancy, sexual orientation, gender identity, gender expression, genetic information, actual or perceived physical or mental disability, registered domestic partner status, caregiver status, marital status, veteran or military status, citizenship status, or any other legally protected category. Delta Dental is committed to providing equal employment opportunities to all employees and applicants for employment. Accordingly, we have adopted and maintain an Equal Employment Opportunity Policy, Harassment-Free Work Environment Policy, and Respectful Workplace policies and will not tolerate violations of these policies. Unfortunately, our Delta Dental Enterprise is unable to hire individuals residing in Alaska, Hawaii, Maine, Nebraska, New Hampshire, North Dakota, Oklahoma, Vermont, West Virginia, Wyoming, Washington DC, Puerto Rico or other US Territories or outside of the United States at this time.