Dental Insurance Verification Specialist – US Insurance (Night Shift)

Dental Insurance Verification Specialist – US Insurance (Night Shift)

Work Mode: Remote
Working Time: US Shift
Notice Period: Immediate
Work Type: 6 months extendable contract
Experience: 0-1 year

Role Overview

Responsible for calling US dental insurance payors to complete detailed insurance verification forms for dental patients, ensuring accurate coverage information, correct dental codes, and smooth revenue cycle operations.

Key Responsibilities

Call US dental insurance payors to verify eligibility, benefits, and coverage for planned dental procedures before appointments.
Complete insurance verification forms with detailed benefit information (annual max, remaining benefits, frequencies, waiting periods, missing tooth clause, posterior composites, etc.).
Verify and interpret dental procedure codes (CDT) and associated coverage, limitations, exclusions, and fee schedule details.
Confirm plan details such as copays, deductible, coinsurance, UCR/fee schedule, in‑network vs out‑of‑network status, and pre‑authorization requirements.
Document all call outcomes and benefit details in the practice management/RCM system accurately and in a standardized format.
Liaise with internal Dental RCM/billing teams to clarify coverage issues and support accurate claim submission and patient estimates.
Escalate complex benefit or coordination‑of‑benefits (COB) issues to senior RCM team members when needed.
Maintain productivity and quality targets for number of verifications and accuracy per shift.

Required Skills and Experience

0-1 year of experience in Dental Revenue Cycle Management (RCM), especially insurance verification, eligibility, or dental billing.
Strong working knowledge of dental insurance concepts: eligibility, benefits, COB, PPO/HMO, waiting periods, frequencies, downgrades, and common denial reasons.
Hands‑on experience with dental procedure codes (CDT) and dental coverage rules for common procedures (prophy, fillings, crowns, root canals, perio, implants, etc.).
Prior experience speaking directly with US insurance payors via phone for verification, benefits clarification, or claim follow‑ups.
Excellent English communication skills (spoken and written) with clear, confident telephone etiquette and ability to probe for detailed benefits.
Strong attention to detail, documentation accuracy, and ability to follow standardized verification checklists.
Familiarity with dental practice management/RCM software or insurance web portals is preferred.