Dental Claims Processing Specialist at Winning… · Philippin…

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.