Eligibility Checkers

Virtual Staffing Solutions is looking for Eligibility Checkers. The Eligibility Checker is responsible for verifying patients' insurance coverage and benefits specifically related to orthodontic treatment. This role ensures that accurate insurance information is available prior to consultations or treatment, enabling efficient claims processing and patient communication.

• Review and verify patient insurance eligibility for orthodontic procedures via online portals or by phone.
• Confirm coverage details including plan type, orthodontic lifetime maximums, deductible, co-pay, coinsurance, and frequency limitations.
• Document all insurance information accurately in the patient management system.
• Communicate with insurance companies to clarify benefit details as needed.
• Flag and escalate issues such as ineligible coverage, policy terminations, or unusual plan exclusions.
• Coordinate with front office or scheduling teams to ensure patients are informed of their coverage prior to treatment.
• Maintain up-to-date knowledge of insurance providers' policies and orthodontic codes (e.g., D8080, D8090).
• Meet performance standards for productivity, accuracy, and turnaround time.

• Prior experience in insurance verification, preferably in dental or orthodontic setting.
• Strong understanding of dental/orthodontic benefits and common procedure codes.
• Familiarity with insurance portals (e.g., Delta Dental, MetLife, Cigna) and EHR systems.
• Excellent attention to detail and data accuracy.
• Strong communication and interpersonal skills.
• Ability to work in a fast-paced, deadline-driven environment.

We specialize in delivering innovative solutions and exceptional services to meet the diverse needs of our clients. With a strong commitment to quality and customer satisfaction, we strive to exceed expectations and drive success in every project we undertake.