Dental Insurance Claims & RCM Advisor — Bilingual (Spanish/English), Remote
Fluent Spanish (spoken and written) — required. Cielo Health LLC is a newly formed, U.S.-based dental claims administration company currently in its startup phase. We manage the full revenue cycle for dental practices — eligibility verification, CDT coding, ADA claim forms, submission, follow-up, appeals, and payment posting — with a focus on American patients treated out-of-network (OON), including cross-border care. Because we're building our operation from the ground up, we're looking for an experienced advisor to help us make the right decisions early and set up best practices from day one. This is a great fit for someone who enjoys shaping a new operation. Fluent Spanish is required, as our leadership communicates primarily in Spanish. What you'll advise us on
- Software: Best eligibility verification, clearinghouse, and RCM/billing platforms for a third-party billing company (e.g., SuperDial, Onederful/Vyne, Zentist) — pros and cons for our model.
- Process: End-to-end claims workflow, from verification and CDT coding to denial management, appeals, and payment tracking.
- Out-of-network claims: Best practices for OON submission, reimbursement, and patients treated abroad.
- Compliance: HIPAA obligations as a Business Associate, processing under the treating provider's identity (we do not use our own NPI), and any state-level rules for third-party billers.
- Insurance: What policies our company should carry (professional liability/E&O, cyber, general liability).
Required qualifications
- Proven experience in U.S. dental insurance claims and/or dental RCM.
- Working knowledge of HIPAA, CDT codes, and ADA claim forms.
- Fluent Spanish (spoken and written) — required.
Preferred qualifications
- Experience with dental claims for foreign, overseas, or cross-border clinics.
- Experience inside a third-party dental billing company and with OON claims.
How to apply Share your relevant experience, the practices and payers you've worked with, and any cross-border or international claims experience. Pay: From $400.00 per week Work Location: Remote