Job Description – Dental Insurance Plan Build Specialist (Denticon)
Job Title
Insurance Plan Build Specialist – Denticon
Department
Revenue Cycle Management (RCM)
Employment Type
Full-Time / Part-Time / Contract (Remote)
Reports To
RCM Operations Manager / Insurance Configuration Manager
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Position Summary
The Insurance Plan Build Specialist is responsible for creating, configuring, maintaining, and validating insurance plans within the Denticon Practice Management System. This role ensures accurate insurance setup, fee schedules, payer information, coverage rules, and plan configurations to support efficient patient billing, insurance claim processing, and revenue cycle operations.
The ideal candidate should possess strong knowledge of dental insurance plans, Denticon system configuration, and dental revenue cycle processes.
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Key Responsibilities
Insurance Plan Configuration
- Create new insurance plans in Denticon.
- Configure PPO, HMO, Medicaid, and Commercial insurance plans.
- Maintain accurate carrier and payer information.
- Update existing insurance plans as required.
- Configure group numbers, employer information, and payer details.
- Configure deductibles.
- Configure annual maximums.
- Configure waiting periods.
- Configure frequency limitations.
- Configure age limitations.
- Configure coverage percentages.
- Configure coordination of benefits when applicable.
Eligibility Verification Support
- Review insurance eligibility documentation.
- Verify benefits against payer portals.
- Update insurance information based on verification.
- Identify discrepancies before patient appointments.
Quality Assurance
- Perform insurance plan audits.
- Validate plan accuracy before production use.
- Test plan functionality.
- Resolve configuration issues.
- Maintain documentation of changes.
Data Maintenance
- Update payer information.
- Maintain carrier addresses.
- Update payer IDs.
- Maintain electronic claims information.
- Archive inactive insurance plans.
Collaboration
o Insurance Verification Team
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Required Qualifications
- High School Diploma or equivalent (Associate or Bachelor's degree preferred)
- 3+ years of Dental Insurance experience
- 1+ year of Denticon experience preferred
- Experience in dental revenue cycle management
- Knowledge of dental terminology
- Knowledge of CDT coding
- Understanding of PPO/HMO plans
- Experience reading insurance fee schedules
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Preferred Skills
- Denticon Insurance Plan Build
- Insurance Verification
- Fee Schedule Configuration
- Electronic Claims Knowledge
- Dental Insurance Benefits Interpretation
- Revenue Cycle Management
- Microsoft Excel
- Data Entry Accuracy
- Problem Solving
- Documentation Skills
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Technical Skills
- Denticon Practice Management Software
- Insurance Carrier Portals
- Microsoft Office Suite
- Excel
- Outlook
- Teams
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Key Performance Indicators (KPIs)
- Number of insurance plans built per day
- Plan accuracy rate
- First-pass configuration accuracy
- Fee schedule accuracy
- Turnaround time for new insurance setup
- Error rate
- Quality audit score
- Timely completion of requested updates
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Working Conditions
- Remote
- Flexible work schedule based on business needs
- Occasional overtime during implementation projects
- Secure internet connection required for remote work
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Preferred Experience
Candidates with experience in one or more of the following are highly preferred:
- Denticon Practice Management System
- Dental Revenue Cycle Management (RCM)
- Dental Insurance Verification
- Insurance Plan Build and Maintenance
- PPO Fee Schedule Manage
Pay: ₹25,000.00 - ₹35,000.00 per hour
Work Location: Remote
