We are seeking a detail-oriented and patient-focused Pediatric Dental Billing Specialist to join our growing dental team. This role is essential to keeping our practice running smoothly by managing dental insurance billing, claim follow-up, and patient financial communication.

The ideal candidate has experience with CDT dental coding, dental insurance billing, and Medicaid plans, along with strong organizational and communication skills. You will help ensure claims are processed accurately while supporting families in understanding their dental benefits.

Key Responsibilities

Insurance Claims & Dental Coding

Prepare and submit accurate dental insurance claims using CDT (Current Dental Terminology) codes. Review charts to ensure procedures are properly coded for common pediatric dental services including preventive care, restorative treatment, extractions, and sedation when applicable.

Insurance & Medicaid Coordination

Verify benefits, submit claims, and communicate with insurance carriers to resolve payment delays or denials. Serve as a resource for Medicaid dental plans and managed care insurance programs.

Accounts Receivable & Claim Follow-Up

Monitor accounts receivable and insurance aging reports. Follow up on outstanding claims, manage denials, submit appeals when appropriate, and post insurance payments and adjustments.

Patient Financial Communication

Assist families with billing and insurance questions by explaining EOBs, treatment estimates, and coverage details. Maintain a supportive and professional approach when discussing financial responsibilities.

Reporting & Documentation

Use Microsoft Office (Excel, Word, Outlook) to track reports, prepare insurance correspondence, and maintain organized billing records. Ensure documentation meets payer requirements and HIPAA compliance standards.

Credentialing Support (Preferred)

Assist with provider credentialing and insurance enrollments, including maintaining CAQH profiles and updating payer participation when needed.

Qualifications

Experience

Minimum 2 years of dental billing or dental insurance coordination experience

Medicaid Knowledge

At least 1 year working with Medicaid dental plans

Coding Knowledge

Strong familiarity with CDT dental codes and dental insurance billing procedures

Technology Skills

Comfortable using Microsoft Office (Excel, Word, Outlook)

Experience with dental practice management software (Oryx or similar systems preferred)

Professional Skills

Strong attention to detail

Excellent communication and organization

Ability to explain insurance benefits clearly to patients and families

Preferred

Credentialing or provider enrollment experience

Pediatric dental experience

Bilingual Spanish speaking