DELTA DENTAL: RCM Projects Specialist

Role description

We are seeking an experienced and detail-oriented RCM Project Specialist, to support ongoing revenue cycle readiness efforts and special initiatives across our organization. This individual will play a key role in researching billing strategy, credentialing pathways, payer requirements, and documentation protocols to help inform and develop new RCM workflows that align with evolving clinical offerings.

This role will partner closely with RCM leadership to ensure operational preparedness, support strategic planning, and lay the foundation for scalable processes as we continue to grow.

Responsibilities

• Conduct payer-specific research related to billing codes, reimbursement rules, and credentialing requirements across medical and dental payers.
• Evaluate documentation and compliance requirements to support clean claim submission and payment integrity.
• Advise on billing workflow design and payer strategy for emerging service lines and operational models.
• Collaborate with internal stakeholders to define RCM processes that support implementation, optimization, and scalability.
• Assist in drafting SOPs, decision trees, and reference guides to support both RCM teams and clinical operations.
• Assist in building and monitoring billing pilot, reporting weekly on status and findings.