Insurance Account Representative

Dental Insurance Claims Specialist Who We Are OrthoSynetics is a national healthcare services company supporting 300+ orthodontic and dental practices across the country. We provide the expertise, technology, and business support that helps practices run better and grow—from marketing and technology to revenue cycle management, HR, purchasing, and more. We’re a team of problem-solvers who believe in taking ownership, working together, and finding better ways to get the job done. When you join us, you’re helping practices succeed behind the scenes so they can focus on their patients. The Opportunity Insurance claims don’t always go according to plan—and that’s where you come in. We’re looking for a Dental Insurance Claims Specialist who knows dental insurance and enjoys figuring out the why behind an unpaid claim. You’ll work directly with insurance carriers to investigate outstanding orthodontic claims, identify what’s holding up payment, and take the necessary steps to get claims resolved. This isn’t a role where you simply work a queue. You’ll need to dig into the details, spot issues, make decisions, and follow a claim through to resolution. Who You Are You know your way around dental insurance, EOBs, denials, eligibility, and claim follow-up—and you’re not intimidated when the answer isn’t obvious. You’re persistent when an insurance carrier gives you the runaround. You notice when something doesn’t add up. You know when you can solve an issue yourself and when it needs to be escalated. Most importantly, you take ownership. You don’t just document that a claim wasn’t paid—you figure out what needs to happen next. What You’ll Do * Work unpaid orthodontic insurance claims that are 30+ days old. * Contact insurance carriers to investigate non-payment and determine next steps. * Review and interpret EOBs, insurance reports, financial screens, and collection reports. * Re-file eligible claims and make corrections as needed. * Update insurance information and estimated insurance portions. * Maintain accurate account information and make necessary adjustments. * Resolve tickets assigned to the OIS Call Center. * Partner with OIS Account Managers and dental offices to resolve outstanding issues. * Provide daily updates on claim activity, issues, and items requiring follow-up. * Manage a high volume of claims while staying accurate and organized. What You Bring * 2–4 years of hands-on dental billing and dental insurance experience. * Experience working dental or orthodontic claims through resolution. * Strong understanding of dental insurance, EOBs, denials, eligibility, benefits, and claim follow-up. * Ability to research a problem, determine the next step, and see it through. * Strong computer skills, including Outlook, Word, and Excel. * High school diploma or equivalent. You’ll Thrive Here If You Are * A problem-solver who likes figuring out why something isn’t working. * Persistent and comfortable following up with insurance carriers. * Detail-oriented and quick to catch discrepancies. * Organized and able to manage competing priorities. * Confident and professional when communicating with carriers, offices, and internal teams. * Comfortable working independently and taking ownership of your workload. Why You’ll Like It Here You’ll be part of a team that plays a direct role in the financial success of 300+ dental and orthodontic practices. Your work matters—you’re helping turn unpaid claims into revenue and making sure practices get the reimbursement they’ve earned. If you know dental insurance, love solving problems, and don’t give up when a claim gets complicated, we want to meet you.