Avatar BPO Solutions

RCM Specialist – Front-End Focus

Views: 41|Published on: Dec 02, 2025

Accounting / Finance

+3 more

Mid Level

Full Time

Vacancy: 1

On Site|

Experience: More than 1 year|

Not Disclosed

Job Description

Roles and responsibilities of this job

Department: Revenue Cycle Management (RCM)

Role Overview:

The Front-End RCM (Revenue Cycle Management) Specialist ensures accurate and timely processing of patient insurance information, authorisations, and claim submissions — the first step in a clean revenue cycle.

Key Responsibilities:

Verify patient insurance eligibility and dental benefits via portals and phone.
Obtain and manage pre-authorisations for dental procedures.
Review clinical documentation and assign CDT codes.
Submit clean claims via clearinghouses (e.g., DentalXChange, ApexEDI).
Track claim status and flag potential issues early.
Maintain detailed insurance notes in Open Dental/Dentrix.
Update daily verification and submission trackers.

Perks & Benefits

Hands-on training with U.S. billing partners
Exposure to advanced dental billing processes
Career growth opportunities in RCM leadership

Job Specification

Required qualifications for this job

Required Education Level:Under Graduate (Bachelor)

Required Experience:More than 1 year

Other Specification

1–2 years of U.S. dental or medical billing experience
Familiarity with CDT codes, dental terminology, and insurance types (PPO, HMO, Medicaid)
Experience with Open Dental or Dentrix preferred
Proficient in Excel/Google Sheets
Strong English communication skills and attention to detail

Performance KPIs

Insurance Verification Turnaround Time
Clean Claim Submission Rate
Pre-Authorization Approval Rate
Denial Rate due to Front-End Errors

Working Hours: 7:45 PM to 3:45 AM NPT (40 hours/week)

Skills Required

Required skills for this job

Communication

Documentation

MS Excel

Attention to Detail

Salary

Offered financial and non-financial compensation for this job

Offered Salary:Not Disclosed

Applying Procedure

Click on Login to Apply to get the email address / external link to apply.

Note: You need to be a registered jobseeker to view the applying email address / external link.

Apply Before: Dec 16, 2025

About the organization

Avatar BPO Solutions

Avatar BPO Solutions is a Nepal-based business process outsourcing firm specializing in supporting U.S.-based healthcare practices with operational excellence.

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