Dental Insurance & Billing Specialist

Sola Kids Dental & Orthodontics | Remote

Employment Type: Full-time (40 hours/week)
Schedule: Monday to Friday, 8:00 AM to 4:30 PM Pacific Time
Reports to: ROC Team Leader

About Us
Sola Kids Dental & Orthodontics is a growing dental group in Los Angeles, California, with four offices offering general dentistry and orthodontics to kids, teens, and adults. Our Remote Operations Coordinators (ROCs) work behind the scenes as the Office Manager’s best partner, with one goal: maximize production and collections so our teams can focus on patients.

About the Role
We’re looking for a detail-driven insurance and billing specialist to join our ROC team. You’ll make sure every patient has verified coverage before they walk in, every visit is billed right the first time, every payment lands in the right place, and every ortho account stays accurate from banding to retention. You’ll work across PPO and Denti-Cal (Medi-Cal Dental), for both general dentistry and orthodontics.

What You’ll Own

Eligibility and benefit breakdowns

Verify Denti-Cal and PPO eligibility for scheduled patients ahead of their visits, and flag anyone without active coverage
Build accurate PPO benefit breakdowns in Open Dental (maximums, deductibles, frequencies, waiting periods, coverage percentages, and ortho benefits such as lifetime maximums, age limits, and payment frequency)
Prepare routing slips 2 days ahead so insurance details match the schedule, and check the schedule throughout the day for newly added appointments
Keep patient insurance information clean and current (subscriber details, plan updates, coordination of benefits)
Alert the office and call center to inactive, terminated, or changed coverage so patients can be contacted before their visit

Payment posting and account accuracy

Post PPO and Denti-Cal insurance payments (EOBs/ERAs) quickly and accurately, and keep patient ledgers clean and balanced
Post ---------- payments and keep payment records clean
Upload and attach eligibility and supporting documentation to the correct patient charts and claims

Orthodontic billing

Submit and track orthodontic insurance claims for PPO patients (initial banding, monthly/periodic billing, retention)
Monitor ortho payment plans and patient balances, and flag missed payments or discrepancies
Learn our Denti-Cal ortho process over time (we’ll train you)

Claims follow-up and audits

Work denials, rejections, and aging AR; follow up with carriers and submit appeals when needed
Audit claims and balances proactively so errors are caught early, not “fixed later”
Double-check Denti-Cal and PPO policies to prevent denials and appeals
Keep clear notes in Open Dental, close every loop with the offices, and escalate chart, billing, or documentation issues quickly and clearly

What Good Looks Like (our READY standard)

Routing Slips Prepared: Every patient’s eligibility is verified before they arrive, and routing slips match the schedule so the office can execute immediately.
Ensure Schedule & Record Accuracy: Extreme attention to detail. Insurance and billing information is entered correctly and readable for the office.
Audit & Bill Daily: Breakdowns are accurate, claims are correct, balances make sense, and errors are caught early.
Dedicated to the Office: Strong ownership mindset. You keep a running task list, close loops with confirmation, and take work off the manager’s plate.
Yield Maximum Production: Fewer eligibility surprises, fewer denials, fewer billing mistakes, and no production left on the table.

Requirements

2+ years of US dental insurance experience, including eligibility verification, benefit breakdowns, and payment posting (PPO required)
US orthodontic billing experience and a strong understanding of how ortho insurance pays over the course of treatment
Experience working denials, appeals, and AR follow-up with US carriers
Comfortable with payer portals and phone verifications
Excellent written and spoken English
Able to work ahead of the schedule and manage high daily volume without sacrificing accuracy
Proactive and dependable in a remote setting: you close loops and confirm your work
Reliable computer, fast stable internet, and a quiet workspace with backup power and internet
Available to work US Pacific Time hours

Nice to Have

Denti-Cal/Medi-Cal experience (strong plus)
Open Dental experience
Experience with patient financing or payment plan platforms such as ----------
A dental nerd at heart who wants to understand not just the “what” but the “why” behind our policies

Why Join Us

Long-term, stable full-time role
Paid training with a supportive, experienced team

How to Apply
Send the following:

Your resume
A short summary of your dental insurance and ortho billing experience (practices, software used, typical daily volume)