Job Title: Dental Billing & Verification Specialist (US Healthcare)

Job Summary:

We are seeking a highly skilled and comprehensive Dental Billing & Verification Specialist to manage the end-to-end revenue cycle for our US-based dental practices. The ideal candidate will handle everything from pre-appointment eligibility/benefit breakdowns to post-appointment claim submission, payment posting, and denial management. Your primary goal is to ensure clean claim submission, minimize revenue leakage, and accelerate the collection process.

Key Responsibilities:

1. Eligibility & Benefits Verification (EV-BV)

- Insurance Verification: Confirm active patient coverage and eligibility via insurance portals or direct phone calls 48 to 72 hours prior to patient appointments.
- Comprehensive Breakdowns: Obtain detailed insurance breakdowns including annual maximums, deductibles, frequencies, waiting periods, missing tooth clauses, and age limits.
- System Updates: Accurately update patient records and insurance fee schedules in the Dental Practice Management Software (PMS).

2. Claims Management & Billing

- Claim Submission: Generate and submit clean electronic and paper claims (with necessary attachments like X-rays, periodontal charts, and narratives) using ADA claim forms.
- Coding Compliance: Audit clinical notes to ensure accurate application of CDT (Current Dental Terminology) codes and appropriate modifiers.
- Coordination of Benefits (COB):



Correctly sequence and bill primary, secondary, and tertiary insurance plans.

3. Payment Posting & AR Follow-Up

- Payment Posting: Accurately post insurance payments from Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs) into patient accounts.
- Denial Management: Review, research, and appeal denied, rejected, or short-paid claims in a timely manner.
- Accounts Receivable (AR): Monitor aging AR reports, follow up with insurance payers on outstanding claims, and handle patient billing inquiries professionally.

Required Skills & Qualifications:

- Experience: Minimum 1 to 3 years of hands-on experience in US Dental Billing and Verification.
- Technical Knowledge: Deep understanding of PPO, HMO, DHMO, Medicaid, and Indemnity plans, alongside complete mastery of CDT codes.
- Software Proficiency: Expert knowledge of dental billing platforms and clearinghouses (e.g., Dentrix, Eaglesoft, Open Dental, eCentral, Change Healthcare, or DentalXChange).
- Communication Skills: Excellent spoken and written English. Must have solid negotiation and communication skills for regular phone interactions with US insurance companies.
- Compliance: Strict adherence to HIPAA guidelines and protecting patient health information.

Work Requirements:

- Shift Timing: Alignment with US business hours (Eastern, Central, or Pacific time zones).

📌 Dental Billing & Verification Specialist (US Healthcare) (Vadodara)
🏢 Meditab India
📍 Vadodara