Dental Claim Processing Expert
6 days ago
Job Overview
We are seeking a highly motivated and detail-oriented Dental Claims Specialist to join our team. As a key member of our operations, you will play a critical role in delivering exceptional service to our customers by managing and processing claims, resolving issues, and providing support while upholding our commitment to quality and integrity.
Key Responsibilities
- Follow-up status of outstanding insurance claims, ensuring all follow-ups are properly documented and communicated with the patient's account updated accordingly.
- Send out claims and attachments to insurance companies.
- Determine denial validity and address them appropriately.
- Generate OI reports and ensure timely completion.
- Claim resubmission and reprocessing, including grievance and appeals.
- Clear rejected claims on a weekly basis.
- Update the weekly office tracker to include all payments posted and confirm if all rejected claims were addressed.
- Complete all assigned follow-ups on office spreadsheets.
- Generate EFT reports and retrieve EOBs from insurance portals for posting at 100%.
- Post insurance payments according to office preference, uploading EOBs and applying adjustments as necessary.
- Identify and communicate any insurance process updates or issues with the team.
- Maintain professionalism at all times, adhering to work ethics and observing the scheduled work time.
- Achieve desired goals and accomplish tasks in a timely manner.
- Communicate effectively with the manager in case of any attendance-related concerns.
Required Skills & Qualifications
- Strong command of verbal and written English and excellent interpersonal skills with minimal accent when speaking.
- Background in dental insurance or collections industries.
- Minimum 3 years of hands-on collections experience.
- Highly motivated individual with outstanding organizational, time management, and follow-up skills.
- Ability to work independently in a remote setting.
- Optional: HMO plan with 1 free dependent upon hire (with dental coverage).
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