Insurance Verification Specialist

We're hiring an Insurance Verification Specialist to verify patient coverage and benefits for US medical and dental practices. Accurate verification is what keeps claims clean, patients informed, and the practice paid — so we need someone experienced who works carefully and independently, not someone learning the process on the job.

Responsibilities

• Verify eligibility and active coverage with carriers before scheduled appointments
• Confirm plan specifics: deductibles, copays, coinsurance, out-of-pocket maximums, annual maximums (dental), frequency limitations, waiting periods, and non-covered services
• Perform verification through carrier portals (Availity, DentalXChange, Navinet, United Concordia, Cigna, Aetna, MetLife, Delta Dental) and by phone when portals fall short
• Break down and document patient responsibility clearly for the front office
• Obtain prior authorizations, pre-determinations, and referrals when required
• Verify coordination of benefits (COB) for patients with dual coverage
• Enter and update accurate insurance details in the practice management system
• Flag terminated policies, coverage gaps, or discrepancies before the date of service

Required Skills & Experience

• 2+ years of hands-on insurance verification experience for US medical and/or dental practices
• Working knowledge of plan types: PPO, HMO, EPO, POS, Medicare, and Medicaid
• Fluent in insurance terminology — eligibility, benefits, deductibles, coinsurance, COB, prior authorization, pre-determination
• Hands-on experience with carrier portals such as Availity, DentalXChange, or NEA, and comfortable calling carriers directly when needed
• Experience in practice management / EHR systems — Dentrix, Eaglesoft, Open Dental (dental) or athenahealth, eClinicalWorks, Kareo, NextGen (medical)
• For dental: understanding of CDT codes, annual maximums, and frequency limitations
• For medical: familiarity with CPT/ICD-10 codes and medical necessity requirements
• Strong grasp of HIPAA and patient confidentiality
• Excellent attention to detail and accurate data entry
• Clear spoken and written English for carrier calls and front-office communication
• Reliable internet, a quiet workspace, and availability during US business hours

In your application, let us know whether you've handled medical, dental, or both, which carrier portals and practice management systems you've worked in, and your typical daily verification volume.