Aging Claims Resolution Specialist

Job Overview

MODPractice is seeking a focused, detail-driven Aging Claims Specialist to support dental practices by resolving outstanding insurance claims and reducing accounts receivable. This role is dedicated to insurance AR follow-up and requires a strong understanding of payer behavior, documentation requirements, and effective escalation strategies.

The ideal candidate is persistent, organized, and comfortable working with aging claims daily while maintaining clear documentation and measurable productivity. This position plays a direct role in improving cash flow for our client practices and supporting sustainable revenue-cycle systems.

Key Responsibilities

-Resolving outstanding dental insurance claims over 30 days from oldest to newest to drive timely payment.
-Research claim delays, denials, and underpayments; identify root causes and take corrective action.
-Submit corrected claims, appeals, narratives, and supporting documentation as required by payers.
-Communicate directly with insurance carriers via phone and online portals to obtain claim status and resolution.
-Accurately post insurance payments and adjustments once claims are resolved.
-Maintain thorough, organized documentation of all claim activity and follow-up efforts.
-Identify payer trends, recurring denial issues, or process breakdowns and escalate appropriately.
-Collaborate with internal MODPractice team members and client offices to correct eligibility, coding, or documentation issues impacting claims.
-Ensure compliance with HIPAA, payer guidelines, and MODPractice revenue-cycle standards.
-Productivity Expectations & KPIs

This role is performance-driven with clearly defined productivity benchmarks:
Minimum Productivity Requirement: 30 insurance claims worked per day (baseline expectation)

Tiered Performance Bonuses:
-Tier 1 Bonus: 45 claims worked per day
-Tier 2 Bonus: 60 claims worked per day

“Claims worked” includes documented follow-up activity such as calls, portal actions, corrections, appeals, and payment posting where applicable.

Qualifications
-Experience: Minimum of 2 years of hands-on dental insurance aging and accounts receivable experience.
-Strong understanding of dental insurance workflows, EOB interpretation, and payer follow-up strategies.
-Proficiency with dental practice management software (Dentrix, Eaglesoft, Open Dental, etc.) and insurance portals.
-Working knowledge of CDT codes and common denial reasons.
-Highly organized with excellent attention to detail and time management skills.
-Comfortable working independently in a structured, KPI-driven environment.
-Clear, professional communication skills—both written and verbal.
-Ability to maintain consistency, accuracy, and productivity in a fast-paced environment.

Why MODPractice
MODPractice partners with dental practices to create revenue-cycle systems that are efficient, ethical, and sustainable. We value clarity, accountability, and professionalism—while providing the tools and support needed for team members to succeed.

How to Apply
Please complete the virtual interview at:
app.xinterview.ai/direct_invite/816ceba8-466a-4f9e-a792-a0b693107f7d

We will follow up with an interview request after reviewing your application.