Senior Dental Revenue Cycle Analyst / Insurance A/R Specialist

Job DescriptionSenior Dental Revenue Cycle Analyst / Insurance A/R Specialist

Location: Remote

Practice: Smile Lab Dentistry — Manhattan, New York

Engagement: Contract / Contract-to-Hire

Smile Lab Dentistry is a high-volume, multi-specialty dental practice in Manhattan. We are looking for an experienced dental revenue cycle professional to help us build stronger internal oversight of our insurance billing, accounts receivable, and overall revenue cycle.

Our insurance verification and billing functions are currently outsourced. This role is not initially intended to replace our outsourced billing team. Instead, we are looking for someone who can independently analyze our revenue cycle, audit performance, identify revenue leakage and process gaps, and help establish consistent reporting, controls, and KPIs.

This is not a basic claims-processing role. We are looking for someone who understands how to follow the financial story of a dental patient from insurance verification through claim adjudication, payment, adjustment, denial, appeal, transfer to patient responsibility, and final collection.

Responsibilities

• Review and analyze insurance A/R and aging
• Audit high-dollar and aged claims
• Review dental patient ledgers and reconcile billed, allowed, paid, adjusted, and outstanding balances
• Analyze EOBs and ERAs
• Identify payer underpayments and discrepancies
• Review rejected and denied claims and determine root causes
• Evaluate appeals and resubmissions
• Audit insurance balances transferred to patient responsibility
• Compare insurance verification information against final payer adjudication
• Identify potentially preventable transfers, denials, write-offs, and collection leakage
• Review patient A/R following insurance adjudication
• Monitor outstanding claims and follow-up activity
• Analyze performance by payer, provider, procedure/CDT code, and denial reason
• Create weekly and monthly revenue-cycle KPI reporting
• Help establish internal controls and workflows for RCM oversight
• Work collaboratively with our outsourced RCM team while independently validating performance
• Recommend process improvements across insurance verification, billing, collections, documentation, and patient responsibility

Ideal Background

• 5+ years of hands-on U.S. dental billing / revenue cycle experience preferred
• Strong experience with PPO dental insurance
• Deep understanding of dental patient ledgers
• Strong knowledge of CDT codes
• Experience with EOB / ERA review and payment reconciliation
• Insurance A/R and aging management
• Denials, rejections, appeals, and resubmissions
• Dental insurance verification and benefit interpretation
• Experience identifying underpayments and payer discrepancies
• Understanding of deductibles, annual maximums, frequency limitations, alternate benefits, downgrades, COB, and non-covered services
• Experience working with multi-provider or multi-specialty dental practices strongly preferred
• Experience with general dentistry, endodontics, periodontics, oral surgery, implants, and restorative procedures is valuable
• Strong Excel / reporting skills
• CareStack experience is highly preferred; Open Dental, Dentrix, or similar dental PMS experience is also valuable

What Success Looks Like

The right person should be able to review a dental ledger and explain:

• What was originally billed
• What insurance was expected to pay
• What the payer allowed
• What insurance actually paid
• What was contractually adjusted
• What became patient responsibility
• Whether the claim was handled appropriately
• Whether additional insurance revenue could have been recovered
• Whether verification, documentation, billing, or follow-up contributed to the outcome
• What action should happen next

This role will initially focus heavily on analysis and auditing. Over time, it may evolve into broader ownership of Smile Lab's revenue-cycle operations and management of internal and outsourced billing resources.

To Apply

Please include:

• Years of dental billing / RCM experience
• Dental PMS platforms you have worked with
• Whether you have used CareStack
• Experience managing insurance A/R and denials
• Experience auditing patient ledgers
• Experience with insurance verification
• Examples of revenue-cycle KPIs you have previously tracked

Candidates with medical billing experience but no meaningful dental billing experience are unlikely to be a fit for this position.