Job Title: Dental Eligibility & Verification Specialist

Job Summary:
The Dental Eligibility & Verification Specialist is responsible for verifying patients’ dental insurance coverage, benefits, and eligibility prior to treatment. This role ensures accurate insurance information is obtained and documented to support proper billing, minimize claim denials, and enhance patient experience.

Key Responsibilities:
- Verify patient dental insurance eligibility and benefits (PPO, HMO, Medicaid, etc.)
- Contact insurance companies via phone or online portals to confirm:
- Coverage effective dates
- Deductibles and maximums
- Frequencies and limitations
- Waiting periods
- Missing tooth clauses
- Downgrade policies
- Document verification details accurately in the practice management system
- Communicate benefit breakdown to front desk and treatment coordinators
- Identify pre-authorization requirements
- Review patient schedules to ensure insurance is verified prior to appointments
- Resolve insurance discrepancies and coverage issues
- Maintain HIPAA compliance and patient confidentiality




- Support billing team to reduce claim denials

Required Qualifications:
- High school diploma or equivalent (Associate’s degree preferred)
- 1+ year experience in dental insurance verification or dental front office
- Knowledge of dental terminology and CDT coding
- Understanding of PPO, HMO, Medicaid, and commercial dental plans
- Experience with dental practice management software (e.g., Dentrix, Eaglesoft, Open Dental)
- Strong attention to detail and data entry accuracy
- Excellent communication and phone skills

Preferred Skills:
- Ability to interpret EOBs (Explanation of Benefits)
- Strong organizational and time management skills
- Ability to handle high call volumes
- Problem-solving mindset

Work Environment:
- Full-time
- Monday-Friday

Job Types: Full-time, Permanent, Fresher

Pay: ₹15,000.00 - ₹17,000.00 per month

Perks:
- Flexible schedule
- Health insurance
- Paid sick

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