Insurance Eligibility Checkers

Job Description 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. Key Responsibilities 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. Skills, Knowledge and Expertise At least 6 months BPO healthcare billing experience is a must Has knowledge in insurance plans Must be able to read eligibility of benefits, denials Excellent communication and comprehension skills Computer literate, in encoding, and word-processing