Dental Insurance Specialist

MEDVA
Summary
Join our team as a highly organized and detail-oriented U.S. Dental Insurance Specialist. You will leverage your extensive knowledge of dental insurance policies, claims processing, and patient account management. This role demands strong communication and attention to detail to ensure smooth insurance reimbursements. Key responsibilities include verifying insurance coverage, submitting claims, handling claim disputes, and communicating with patients about billing. You will also support the billing department and maintain accurate insurance records. Compliance with regulations and HIPAA guidelines is crucial.
Requirements
- High school diploma or equivalent; Associateβs degree or certification in dental billing/insurance is a plus
- 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
Certification in dental insurance billing (e.g., Certified Billing and Coding Specialist, or other relevant certifications) is preferred but not required
Benefits
- Competitive hourly rate
- As an independent contractor, enjoy competitive market rates
- 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
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