WFH Dental Insurance Verification Specialist
Job Overview
Our client is looking for a Dental Insurance Verification Specialist who will be responsible for verifying patients’ dental insurance coverage, eligibility, and benefits prior to scheduled appointments and treatment. This position plays a critical role in reducing claim denials, improving patient communication, and ensuring accurate billing and collections.Schedule: Monday - Friday, 8:00 AM - 5:00 PM EST, with 1 hour unpaid break (40 work hours per week)
Responsibilities
- Verify active dental insurance coverage and patient eligibility prior to appointments
- Confirm detailed benefits including deductibles, frequencies, waiting periods, annual maximums, limitations, and exclusions (e.g., downgrades, missing tooth clauses)
- Check coverage for preventive, basic, major, endodontic, periodontal, oral surgery, and orthodontic services
- Determine in-network/out-of-network status and review coordination of benefits (COB) for patients with multiple plans
- Accurately document verification details in the practice management system and ensure HIPAA compliance
- Follow up with insurance carriers on discrepancies, denied claims, and benefit-related inquiries while coordinating with administrative teams
- Previous dental insurance verification experience preferred, with knowledge of PPO, HMO, and Medicare Advantage plans
- Familiarity with dental terminology, CDT codes, procedures, and dental practice management systems (e.g., Dentrix, Eaglesoft, Open Dental) preferred
- High school diploma or equivalent required
- Strong attention to detail, organization, and ability to multitask, with the ability to work efficiently in a fast-paced environment
- Excellent communication and customer service skills
- Dental insurance eligibility verification
- Coordination of benefits knowledge
- Insurance portal navigation
- Health Insurance Coverage for eligible locations
- Permanent work from home
- Immediate hiring
