Claim Resolution Expert
2 days ago
Dental Claims Specialist Role
As a dental claims specialist, you will play a vital part in delivering exceptional customer service and ensuring timely claim resolution. Your responsibilities will include managing and processing claims, resolving issues, and providing support to our clients while upholding the highest standards of quality and integrity.
Your Key Responsibilities:
- Follow-up on outstanding insurance claims, documenting all interactions and communicating effectively with patients and their families.
- Process and submit claims to insurance providers, ensuring accurate and timely documentation.
- Analyze denial validity and take appropriate action to resolve these issues efficiently.
- Generate operational reports and maintain accurate records of claim status.
- Resubmit and reprocess rejected claims, including grievances and appeals.
- Clear rejected claims on a weekly basis, updating office trackers as necessary.
- Complete all assigned follow-ups, utilizing office spreadsheets for tracking progress.
- Retrieve Electronic Funds Transfer (EFT) reports and EOBs from insurance portals for posting 100% accuracy.
- Post insurance payments according to office preference, always uploading EOBs and applying corrections or adjustments as needed.
- Monitor insurance process updates and communicate findings with the team to ensure seamless operations.
- Maintain professionalism at all times, adhering to work ethics and schedules.
- Meet desired goals and accomplish tasks within specified deadlines.
- Communicate effectively with managers in cases of absence or other issues.
About You:
- You possess a strong command of verbal and written English, with excellent interpersonal skills and minimal accent when speaking.
- You have a background in dental insurance or collections industries.
- You hold at least 3 years of hands-on collections experience.
- You are highly motivated, detail-oriented, and able to work independently as this is a remote position.
- You excel in organizational, time management, and follow-up skills.
- We offer HMO coverage with 1 free dependent upon hire (with dental coverage).
Why This Role?
This role presents an exciting opportunity to join our organization and contribute to delivering exceptional service to our customers. If you possess the required skills, qualifications, and attitude, we encourage you to apply for this challenging yet rewarding position.
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