Job Description

We are seeking an experienced, detail-oriented, and highly reliable Virtual Dental Biller - Open Dental EHR to manage full-cycle dental claims, payment posting, and insurance reconciliation. In this key role, you will take full ownership of claim submissions using accurate CDT coding, audit dental records for compliance, process insurance adjustments and patient refunds, and resolve rejected or denied claims.

The ideal candidate works independently with high efficiency, maintains clear communication with clinical and front-office teams, and easily keeps up with the fast pace and rigorous quality standards of a high-volume dental billing department.

Working Environment & Core Schedule

• Role Title: Virtual Dental Biller / Claims Specialist
• Status: Full-Time (40 Hours / Week)
• Schedule: Monday – Friday, 7:00 AM – 4:00 PM PST (Pacific Standard Time)
• Core Systems: Dental Practice Management Software (DPMS), Insurance Payor Portals, Clearinghouses
• Specialty Focus: General & Specialty Dental Billing

Top 3 Daily Tasks

1. Dental Claims Management & CDT Submission: Prepare, audit, and submit primary and secondary dental claims with accurate CDT codes, attachments (x-rays, perio charts), and clinical narratives; correct and resubmit rejected claims promptly.
2. Payment Posting & Insurance Reconciliation: Post electronic (EFT/ERA) and manual insurance payments, audit line-item adjustments, identify overpayments, and initiate patient refunds for accounts paid in full by insurance.
3. Billing Compliance & Quality Audits: Verify that submitted claims match treatment notes rendered, conduct routine chart/billing audits to prevent compliance errors, and collaborate with staff to meet payor rules.

Core Responsibilities

• End-to-End Claim Management: Audit claim queues daily, ensuring clean submission of dental claims with appropriate CDT coding, valid subscriber information, and required clinical attachments.
• Denials & Rejections Resolution: Work claim rejections and denials systematically, communicating with dental insurance payors to resubmit corrected claims or supporting clinical documentation.
• Payment & Refund Processing: Post daily and quarterly insurance bulk payments by patient and office location, maintaining meticulous documentation for all adjustments, write-offs, and patient refund requests.
• Cross-Team Collaboration & Compliance: Partner with clinical providers and front desk staff to resolve coding discrepancies, gather missing treatment documentation, and ensure strict alignment with dental insurance policies.

Requirements

Required Qualifications

• U.S. Dental Billing Experience: Minimum 2+ years of hands-on experience managing U.S. dental billing, claims processing, and payment posting.
• CDT Coding Mastery: In-depth knowledge of Current Dental Terminology (CDT) codes, dental insurance rules, radiograph/attachment requirements, and claim submission standards.
• Payment Posting & Reconciliation: Proven skill in posting ERAs/EOBs, reviewing line-item adjustments, and managing patient balance/refund workflows.
• Reliability & Autonomous Execution: Strong self-management skills with the ability to work independently, maintain high accuracy, and keep up with daily departmental billing quotas.
• Communication & HIPAA: Excellent written/spoken English communication and strict compliance with HIPAA privacy and patient record security standards.
• Remote Workspace: Dedicated, private home office setup with a high-speed PC/Mac, primary high-speed internet, backup power/internet solutions, and a quiet working environment.

Preferred Qualifications

• Experience using popular Dental Practice Management Systems (e.g., Dentrix, Eaglesoft, Open Dental, or Curve Dental).

Ideal Candidate Profile

You are a seasoned dental billing professional who understands CDT coding inside and out. You audit claims with meticulous precision, resolve insurance rejections quickly, keep financial ledgers balanced, and execute your billing workflows with absolute reliability every day.