Dental Virtual Assistant - PE/CR

We are looking for experienced Dental Virtual Assistants to support US-based dental practices and healthcare providers. The ideal candidate has direct experience working in the US dental industry, with knowledge of dental insurance, patient scheduling, eligibility and benefits verification, treatment coordination, prior authorizations, and dental practice operations. As a key member of a US-based dental practice, the Dental Healthcare Virtual Assistant acts as a liaison between patients, dental providers, and insurance companies. The role requires a detail-oriented, tech-savvy professional who can navigate dental insurance portals and practice management systems while providing accurate information and a high level of patient support.

Dental Insurance Verification & Eligibility
Verify patient eligibility and dental insurance benefits prior to appointments and treatment.
Review dental insurance plans and accurately interpret coverage, limitations, exclusions, deductibles, copays, coinsurance, and annual maximums.
Identify waiting periods, frequency limitations, missing tooth clauses, downgrades, and other plan-specific restrictions.
Determine and document estimated patient financial responsibility based on available insurance benefits.
Verify coverage for preventive, diagnostic, restorative, periodontal, oral surgery, and other dental procedures.
Document insurance verification results accurately in the dental practice management system.
Communicate with insurance carriers to clarify benefits, coverage, and patient eligibility when needed.

Dental Scheduling & Patient Communication
Schedule, reschedule, and confirm patient appointments.
Manage provider schedules and appointment availability to support efficient practice workflows.
Conduct inbound and outbound calls with patients regarding appointments, treatment, insurance, and follow-up needs.
Send appointment reminders and follow up with patients regarding missed or incomplete appointments.
Coordinate appointments based on treatment needs, provider availability, and practice protocols.
Provide professional and empathetic patient communication throughout the scheduling and treatment process.

Treatment Coordination & Pre-Authorization
Assist with reviewing treatment plans and determining applicable insurance coverage.
Prepare and submit dental pre-authorizations or predeterminations when required.
Collect and organize supporting documentation, including treatment information, clinical notes, and required images or X-rays.
Track pending pre-authorizations and follow up with insurance carriers.
Communicate authorization outcomes and insurance information to the appropriate dental practice team.
Help identify potential coverage issues before treatment to reduce unexpected patient costs.

Dental Billing & Insurance Support
Assist with dental insurance claims and follow-up activities when required.
Review Explanation of Benefits (EOBs) and insurance responses to identify discrepancies or outstanding issues. Follow up with insurance carriers regarding unpaid, pending, or denied claims.
Assist with claim corrections and provide necessary information to the appropriate billing team.
Support patient questions regarding balances, insurance payments, and estimated out-of-pocket costs.
Escalate complex billing, coding, or coverage issues when appropriate.

Documentation & Practice Operations
Maintain accurate patient, insurance, treatment, and appointment information.
Document all patient and insurance interactions in the appropriate practice management or EHR system.
Navigate dental insurance portals and payer websites to obtain and update patient information.
Maintain organized records and follow established workflows for patient and insurance documentation.
Support additional administrative and operational tasks based on the needs of the dental practice.

Requirements
Experience: Must have at least 1 year of direct experience in the US Dental industry, scheduling, eligibility, prior authorizations, insurance verification, etc.
Available to work full time on any US time zone CST, EST, PST & MST
Core Knowledge: Deep understanding of US insurance concepts, including PPO, HMO, EOBs, copays, and patient benefits eligibility verification, prior auth and scheduling.
Technical Skills: Proficiency in navigating insurance portals (e.g., Availity, Optum, Covermymeds, etc) and electronic health record/practice management systems (e.g., ECW, Tebra, Dentrix etc).
Competencies: Exceptional attention to detail, strong analytical skills, excellent written and verbal English communication, and the ability to work independently in a fast-paced environment.