Benefits Specialist

3+ years of experience in dental insurance eligibility, benefits verification, dental billing, revenue cycle management, or dental practice operations.
Strong knowledge of dental insurance plans, eligibility verification, dental terminology, and CDT procedure codes.
Hands-on experience verifying patient eligibility and obtaining detailed benefit breakdowns through payer portals, electronic eligibility tools, and insurance carrier websites.
Proven experience contacting insurance carriers by phone to clarify incomplete, conflicting, or unclear coverage and benefit information.
Expertise in interpreting annual maximums, deductibles, coverage percentages, frequency limitations, exclusions, waiting periods, age limits, orthodontic benefits, and coordination of benefits.
Ability to research procedure-specific coverage and treatment history to support treatment planning, patient financial estimates, billing, and claims processing.
Experience accurately documenting and maintaining detailed eligibility and benefit information in Epic or other dental practice management systems.
Strong attention to detail with the ability to identify discrepancies, resolve missing information, and escalate complex eligibility issues appropriately.
Excellent verbal, written, and telephone communication skills, with the ability to manage high-volume workloads while meeting accuracy, productivity, quality, and turnaround targets.
Preferred: Experience with Epic or other dental practice management systems, such as Dentrix, Denticon, Eaglesoft, or Open Dental, and knowledge of PPO, Medicaid, and DHMO plans.

Work arrangement
Yes