Dental Insurance Specialist

Summary

Join our team as a U.S. Dental Insurance Specialist! This role requires extensive knowledge of dental insurance policies, claims processing, and patient account management. You will verify insurance coverage, submit claims, handle claim disputes, communicate with patients, and support the billing department. Strong communication, attention to detail, and organizational skills are essential. A minimum of two years of experience in dental insurance is required. We offer a competitive hourly rate, medical benefits, ongoing training, and a permanent work-from-home setup.

Requirements

• High school diploma or equivalent
• Minimum of 2 years of experience in dental insurance verification, claims processing, and billing
• Knowledge of dental insurance plans (PPO, HMO, Medicaid, etc.) is essential
• Proficient in dental insurance claim management software
• Strong understanding of dental insurance policies, procedures, and coding (CPT, CDT)
• Excellent organizational and multitasking abilities
• Strong attention to detail and problem-solving skills
• Ability to communicate effectively with insurance companies, patients, and internal teams
• Familiarity with HIPAA and healthcare privacy laws

Responsibilities

• Verify dental insurance coverage for patients, including confirming eligibility, benefits, and coverage limits prior to treatment
• Submit accurate dental insurance claims to carriers in a timely manner, ensuring all necessary documentation is provided. Follow up on unpaid, denied, or underpaid claims to resolve any issues
• Utilize proper dental coding (CPT, CDT) for procedures and services rendered, ensuring compliance with insurance requirements and federal regulations
• Work directly with insurance providers to resolve claim denials, appeal underpayments, and address any discrepancies between claims and patient statements
• Communicate effectively with patients regarding their insurance coverage, co-pays, deductibles, and out-of-pocket costs. Provide clear explanations of insurance benefits and billing details
• Assist the billing department with patient billing inquiries, and coordinate insurance payments and adjustments to patient accounts
• Maintain accurate and up-to-date insurance records, including patient information, claim status, and correspondence with insurance companies
• Ensure compliance with all dental insurance regulations and policies, as well as maintaining confidentiality according to HIPAA guidelines
• Prepare and submit insurance reports for management, including details on claims status, aging accounts, and overall insurance collection performance

Preferred Qualifications

• Associate’s degree or certification in dental billing/insurance
• Certification in dental insurance billing (e.g., Certified Billing and Coding Specialist, or other relevant certifications)

Benefits

• Competitive hourly rate
• MedVA in-house medical benefits (after 6 months of tenure)
• Ongoing training at no cost, with top-tier learning resources from industry experts
• Permanent work-from-home setup, allowing you to earn from the comfort of your home and avoid stressful commutes while reducing your exposure to illness