Dental Claims Processing Specialist

Job Title: Dental Claims Processing Specialist Position type: Part-Time Working Hours: 12:00 PM – 4:00 PM Central Daylight Time Monday - Friday Salary rate: $5-$6 Key Responsibilities: - Independently manage the end-to-end processing, preparation, review, and submission of dental insurance claims, ensuring accuracy, completeness, and timely filing. - Review dental claims for errors, missing information, and documentation discrepancies before submission to minimize rejections and processing delays. - Investigate denied, rejected, or unpaid insurance claims, identify underlying issues, prepare necessary corrections or appeals, and follow up until resolution. - Prepare and submit supporting clinical documentation, claim attachments, treatment narratives, and other insurance-required information to facilitate claim approvals. - Perform daily claim reconciliation to verify submission accuracy, monitor processing outcomes, and identify discrepancies requiring corrective action. - Monitor outstanding and pending insurance claims, conducting routine status follow-ups approximately every 30 days to ensure timely processing and payment. - Utilize insurance portals and electronic claim management systems to verify claim statuses, track submissions, and address outstanding insurance matters. - Communicate with insurance representatives through occasional phone calls when additional clarification, documentation, or assistance is required. - Maintain accurate and organized records of claim submissions, denials, appeals, follow-ups, and resolutions within the practice management system. - Collaborate closely with the office manager to address complex insurance concerns, resolve claim discrepancies, and coordinate appropriate solutions. - Identify recurring claim issues and recommend improvements to enhance billing accuracy, minimize denials, and maintain efficient claims processing workflows. Requirements - At latest 1 year of hands-on experience in dental insurance billing, claims processing, submissions, denials, and appeals is required. - Strong knowledge of dental insurance procedures, claim reconciliation, and follow-up processes. - Ability to independently manage end-to-end dental claims processing with minimal supervision. - Excellent attention to detail, organizational skills, and problem-solving abilities. - Strong written and verbal English communication skills. - Experience using Open Dental practice management software is strongly preferred. - Familiarity with dental insurance portals and electronic claims submission systems. - Experience preparing dental claim attachments, supporting documentation, and treatment narratives. Basic Requirements - Must speak and write English clearly and professionally. - Must have relevant work experience. - Must be able to provide an NBI Clearance and/or Local Police Clearance before onboarding (mandatory). - Must be available to attend video meetings with camera on when required. Technical Requirements - Computer: Reliable laptop or desktop computer. - Internet: Stable high-speed internet connection (minimum 25 Mbps). - Audio: Noise-canceling headset. - Video: Working webcam for virtual meetings. - Workspace: Quiet and professional work environment. Benefits - Dedicated HR & Contractor Support Team: Access to world-class support for questions, guidance, contract matters, and client communication. - Premium VPN Access (Optional): A secure VPN license can be provided upon request to enhance privacy and security for client-related tasks. - HIPAA & Cybersecurity Training + Certification (Provided): Access to our internal HIPAA compliance training, cybersecurity modules, and certification to help you confidently handle PHI for U.S. healthcare clients. - Top 1% VA Performance Training: Access to our proprietary training on communication, client management, productivity systems, and best practices to help you become a top-performing VA and increase long-term client retention. - Client-Approved U.S. Holidays: Contractors may take U.S. holidays off according to the client’s needs and schedule. - Client-Approved Paid or Unpaid Time Off: Time off may be granted by your client. Paid time off is optional and only if offered by the client. - Access to Tools & Resources: Templates, workflow guides, productivity tools, and client-specific SOP support to help you perform at your best. - Optional Performance-Based Incentives: Some clients may offer bonuses, incentives, or increased hours based on your performance. These are optional resources and client-approved allowances available to you as an independent contractor. Any resources, training, or allowances listed are optional contractor perks and not employee benefits.