Senior Remittance Specialist – Training & Optimization

The Senior Remittance Specialist – Training & Optimization is responsible for accurate insurance payment posting and
reconciliation while also serving as the subject matter expert for onboarding, training, and continuous optimization of
remittance workflows. In addition to daily production responsibilities, this role leads training for new hires, creates and
maintains Standard Operating Procedures (SOPs), and supports process improvement, quality, and compliance initiatives
across the Payments & Remittance team.
This position requires strong attention to detail, advanced system knowledge, and the ability to effectively train, coach,
and standardize processes. This is a 100% remote position.

Key Responsibilities
Payment Posting & Reconciliation
• Accurately post all insurance payments, adjustments, and denials to client accounts in a timely and compliant
manner.
• Review and reconcile check deposits, EFTs, and lockbox reports to ensure completeness and accuracy.
• Ensure all payments are posted in accordance with payer contracts and client‑specific rules.
• Maintain a high level of productivity while meeting or exceeding quality standards (99%+ accuracy).
• Ensure all payments are matched and reconciled on Reconciliation Reports, including clear documentation for
discrepancies.
• Manage the Zentist portal daily to confirm posted payments and completed deposits.
• Assign denied claims to Denial Management and A/R teams within Denticon’s task manager.
• Monitor and process Electronic Remittance Advice (ERA) through DentalXChange.
• Resolve payments received without Explanation of Benefits (EOBs).
• Obtain ERA/EOB files from multiple sources, including DentalXChange, Zentist, payer portals, and direct payer
communication.
• Escalate recurring payer issues or payment variances to the Revenue Cycle Manager.
• Maintain accurate workload reporting within the Daily Tracker for payment posting, reconciliation, and ERA
processing.
• Pre‑audit and escalate fee discrepancies to the Fees Team.
• Initiate refund tickets for payer overpayments.
• Adhere to HIPAA requirements and all internal compliance standards.
Training, Documentation & Optimization
• Serve as the lead trainer and subject matter expert for the Payments & Remittance function.
• Deliver structured onboarding and training for new hires, covering systems, posting standards, reconciliation
requirements, and quality expectations.
• Coach and support team members to reinforce accuracy, efficiency, and compliance.
• Create, update, and maintain Standard Operating Procedures (SOPs) for all remittance and payment posting
workflows.
• Ensure SOPs remain current, audit‑ready, and consistently followed across the team.
• Identify training gaps, quality trends, and process improvement opportunities; partner with leadership on
optimization initiatives.
• Support internal audits and quality reviews through strong documentation and standardized workflows.
• Act as an escalation and knowledge resource for complex posting, reconciliation, and payer‑specific scenarios.
Performance Metrics (KPIs)
• Productivity: Post 30+ payments/adjustments per hour worked; auto‑posted payments included.
• Accuracy: Maintain a minimum 99% accuracy rate across all posting activities.
• Timeliness - Manual Posting: Complete within 2 business days of receipt.
• Timeliness - ERA Reconciliation: Complete within 5 business days of posting.
• Training Effectiveness: New hires achieve defined productivity and accuracy benchmarks within onboarding
timelines.
• Process Optimization & SOP Compliance: SOPs remain current, consistently followed, and support audit and
quality standards.