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Insurance Verification and Billing Specialist

MaKai Consulting, LLC

Insurance Verification & Billing Specialist
Position Overview

We are seeking a highly organized and experienced Insurance Verification & Billing Specialist to support insurance verification and billing operations within our growing practice. This individual will play a critical role in ensuring accurate insurance coverage verification, timely claims processing, and efficient revenue cycle management.

The ideal candidate is detail-oriented, solutions-driven, and experienced in dental, oral surgery, or medical billing environments. Experience with WinOMS is strongly preferred.

Key Responsibilities
Insurance Verification
  • Verify patient insurance eligibility, benefits, authorizations, and coverage accurately and efficiently
  • Resolve insurance discrepancies with patients, providers, and insurance carriers
  • Maintain current knowledge of insurance policies, coding updates, and payer guidelines
  • Ensure verification tasks are completed in a timely and accurate manner
Billing & Revenue Cycle
  • Process claim submissions, payment posting, account follow-up, and denial management
  • Assist with resolving unpaid or denied claims and insurance appeals
  • Monitor aging reports and support collections efforts
  • Ensure billing accuracy and compliance with payer requirements
  • Collaborate with clinical and front office teams to ensure proper documentation and communication
WinOMS Reporting & Operations
  • Utilize WinOMS reporting tools to support office performance and workflow efficiency
  • Provide reporting support for leadership and operational planning
  • Maintain accurate patient and insurance data within practice systems
Additional Duties
  • Provide exceptional customer service to patients and team members
  • Assist with onboarding and training support as needed
  • Maintain HIPAA compliance and confidentiality standards
  • Secure escalated patient situations and find reasonable resolutions
  • Support additional administrative and operational duties as assigned
  • Serve as the contact person for DCS
  • Manage DCS spreadsheet and callback spreadsheet tracking
  • Assist with billing-related WinOMS reporting
Qualifications
  • Minimum of 3 years of dental, oral surgery, or medical insurance verification/billing experience
  • Experience with WinOMS software and reporting functions preferred
  • Strong understanding of insurance claims, billing workflows, and revenue cycle management
  • Proficient with Microsoft Office and reporting tools
Skills & Attributes
  • Strong communication and problem-solving skills
  • Attention to detail and organizational skills
  • Ability to multitask in a fast-paced environment
  • Analytical and reporting capabilities
  • Customer service oriented
  • Professionalism and confidentiality
Why Join Our Team?

We are committed to building a positive, team-oriented culture where growth, accountability, and patient care come first. This is an excellent opportunity for someone looking to make a direct impact on operational success and patient experience.

Apply today to become part of a team that values excellence, collaboration, and professionalism.

Vacancy posted more than 2 months ago
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