Dental Insurance Verification Specialist (US RCM) Full Time

Job description

Lume, inspired by the word “illuminate,” embodies our belief in guiding brands toward clarity, voice, and presence. We specialize in marketing, technology, and creative services, assisting businesses in building momentum through effective strategies, innovative design, and impactful content.

Roles & Responsibilities:

• Verify patient dental insurance eligibility and benefits with US insurance providers prior to treatment.
• Confirm key benefit details including deductibles, annual maximums, waiting periods, and frequency limitations.
• Review and validate PPO/HMO plan coverage, limitations, and exclusions.
• Identify pre-authorization and pre-determination requirements where applicable.
• Accurately update and document verified insurance details in the Practice Management System (PMS).
• Coordinate with front desk, billing, and clinical teams to ensure accurate treatment planning.
• Maintain proper documentation of verification calls and portal checks.
• Ensure compliance with HIPAA guidelines and data confidentiality standards.
• Handle insurance portals and payer communications efficiently.

Requirements:

• Minimum 2+ years of experience in US Dental Insurance Verification or Revenue Cycle Management (RCM).
• Strong knowledge of US dental insurance plans (PPO, HMO, Medicaid, etc.).
• Hands-on experience with Dentrix, Open Dental, Denticon, or similar Practice Management Systems (PMS).
• Familiarity with CDT codes and dental procedures.
• Good understanding of insurance breakdowns and benefit structures.
• High attention to detail and accuracy.
• Good communication skills in English.

Shift Timing: Early morning shift starting from 6:00 AM

Joining Requirement: Preference will be given to candidates who can join immediately.