About the Role

We are looking for a detail-oriented and analytical Auditor – Dental Insurance Verification to review and audit insurance verification work for US dental practices. The candidate will be responsible for ensuring the accuracy, completeness, and quality of insurance eligibility and benefits verification performed by the operations team.

The ideal candidate should have strong hands-on experience in US dental insurance verification, a good understanding of dental insurance benefits, and the ability to identify errors, provide constructive feedback, and help improve overall process quality.

Designation: Auditor – Dental Insurance Verification

Key Responsibilities

· Manage and monitor daily Dental Insurance Verification operations.

· Conduct quality audits of completed dental insurance verification cases.

· Verify the accuracy and completeness of insurance eligibility and benefits information.

· Review active coverage, effective dates, termination dates, and plan details.

· Validate deductibles, annual maximums, remaining benefits, waiting periods, frequency limitations, exclusions, and coverage percentages.

· Audit benefit details for preventive, basic, and major dental procedures.

· Verify coverage information for examinations, X-rays, cleanings, fillings, crowns, root canals, periodontal treatments, and other applicable procedures.

· Ensure copayments, coinsurance, and estimated patient financial responsibility are correctly identified and documented.

· Cross-check verification findings against payer portals, insurance websites, and available source documentation.

· Identify errors, missing information, incorrect benefit interpretations, and deviations from client-specific requirements.

· Ensure verification notes are complete, accurate,



and properly documented in the practice management system.

· Maintain audit reports, quality scorecards, and error-tracking records.

· Provide timely and constructive feedback to insurance verification specialists.

· Identify recurring errors and recommend corrective and preventive actions.

· Coordinate with team leaders and operations managers to address quality issues.

· Support refresher training and process improvement initiatives based on audit findings.

· Monitor adherence to SOPs, quality guidelines, turnaround times, and client SLAs.

· Handle re-audits and follow up on corrective actions to ensure errors are addressed.

· Maintain the confidentiality of patient information and follow applicable HIPAA requirements.

Required Qualifications & Experience

· Minimum 2.5+ years of experience in Dental RCM.

· Hands-on experience in US Dental Insurance Verification and Eligibility Checking.

· Prior experience in quality auditing or quality assurance is preferred.

· Strong understanding of US dental insurance plans, particularly PPO plans.

· Knowledge of deductibles, annual maximums, waiting periods, frequency limitations, exclusions, and insurance benefit percentages.

· Ability to interpret dental insurance benefits and identify discrepancies.

· Experience working with payer portals and insurance company websites.

· Familiarity with dental practice management systems such as Dentrix, Eaglesoft, Open Dental,



Denticon, or similar platforms.

· Good analytical skills and strong attention to detail.

· Proficiency in MS Excel, audit trackers, and quality reporting.

· Positive written and verbal communication skills.

· Ability to provide clear feedback and explain errors to operations teams.

· Ability to manage audit volumes and meet quality reporting deadlines.

Key Performance Indicators (KPIs)

The Auditor will be responsible for monitoring:

· Audit accuracy and consistency

· Number of cases audited per day

· Timely completion of audits

· Error identification and classification accuracy

· Quality scorecard accuracy

· Feedback turnaround time

· Reduction in recurring errors

· Compliance with audit SOPs and client requirements

· Effectiveness of corrective action follow-up

· Overall improvement in verification quality

Preferred Skills

· Strong understanding of US dental insurance verification workflows.

· Ability to distinguish critical errors from minor documentation gaps.

· Excellent observation and analytical skills.

· Strong documentation and reporting abilities.

· Ability to work independently and meet deadlines.

· A proactive approach to quality improvement and process standardization.

· Professional communication and constructive feedback skills.

Job Types: Full-time, Permanent

Pay: ₹25,000.00 - ₹40,000.00 per month

Benefits:

- Flexible schedule
- Food provided
- Health insurance
- Life insurance

Education:

- Bachelor's (Preferred)

Experience:

- Dental RCM: 2 years (Required)
- Auditor: 1 year (Required)

Language:

- Fluent in English Communication (Required)

Shift availability:

- Night Shift (Required)

Work Location: In person

📌 Senior Billing Executive- Eligibility Verification - Voice (Ahmedabad)
🏢 Orient Healthcare Technology
📍 Ahmedabad