Dental Claims Processing Specialist

This is a fully remote position, open to applicants in Philippines.

📋 Description

• Take full responsibility for the end-to-end management, preparation, review, and submission of dental insurance claims.

• Examine claims for inaccuracies, missing details, and documentation inconsistencies.

• Analyze denied, rejected, or unpaid claims and develop corrections or appeals.

• Follow up on claims until they are resolved.

• Prepare and submit clinical documentation, claim attachments, treatment narratives, and any other required information.

• Conduct daily claim reconciliation and pinpoint discrepancies needing corrective actions.

• Track outstanding and pending claims, conducting status follow-ups approximately every month.

• Utilize insurance portals and electronic claim management systems to verify statuses and monitor submissions.

• Engage with insurance representatives via phone when clarification or assistance is necessary.

• Keep organized records of submissions, denials, appeals, follow-ups, and resolutions within the practice management system.

• Work together with the office manager on intricate insurance matters and claim discrepancies.

• Recognize recurring claim issues and propose workflow enhancements.

⛳️ Requirements

• A minimum of 1 year of practical experience in dental insurance billing, claims processing, submissions, denials, and appeals is essential.

• Comprehensive understanding of dental insurance procedures, claim reconciliation, and follow-up methodologies.

• Capability to independently oversee the complete dental claims processing with minimal supervision.

• Exceptional attention to detail, organizational capabilities, and problem-solving skills.

• Proficient written and verbal communication skills in English.

• Experience with Open Dental practice management software is highly preferred.

• Familiarity with dental insurance portals and electronic claims submission systems.

• Experience in preparing dental claim attachments, supporting documentation, and treatment narratives.

• Must articulate and write in English clearly and professionally.

• Relevant work experience is mandatory.

• Must be able to provide an NBI Clearance and/or Local Police Clearance prior to onboarding (mandatory).

• Availability for video meetings with the camera on when required.

• A reliable laptop or desktop computer is necessary.

• A stable high-speed internet connection (minimum 25 Mbps) is required.

• A noise-canceling headset is needed.

• A working webcam for virtual meetings is required.

• A quiet and professional work environment is essential.

🏝️ Benefits

• Dedicated HR & Contractor Support Team

• Premium VPN Access (Optional)

• HIPAA & Cybersecurity Training + Certification (Provided)

• Top 1% VA Performance Training

• Client-Approved U.S. Holidays

• Client-Approved Paid or Unpaid Time Off

• Access to Tools & Resources

• Optional Performance-Based Incentives

• Optional contractor perks and client-approved allowances