Remote Dental Claims Specialist

Summary

The Dental Claims Specialist is responsible for managing and processing claims, resolving issues, and providing support to clients while maintaining quality and integrity. They are expected to follow up on outstanding insurance claims, send out claims and attachments, determine denial validity, generate reports, and update office trackers. The specialist must remain professional, have strong English skills, a background in dental insurance or collections, and at least 3 years of hands-on collections experience. They are expected to be highly motivated, detail-oriented, independent workers with excellent organizational, time management, and follow-up skills. Benefits include HMO with one free dependent upon hire (with Dental coverage), Life Insurance, Night Shift/20% Night Differential, 20 PTO credits annually, a great company culture, career growth and learning opportunities, and the ability to work from home. The salary ranges from 30,000 to 32,000 per month.

Requirements

• Remain professional at all times
• Observe work ethics and adhere to the work time schedule
• Hit the desired goal and accomplish all tasks in a timely manner
• Communicate with the manager in the absence of any attendance issues
• Have strong command of verbal and written English and interpersonal skills
• Background in the Dental insurance or collections industries
• 3+ years of hands-on collections experience

Responsibilities

• Manage and process claims
• Resolve issues and provide support to clients
• Follow up on outstanding insurance claims
• Send out claims and attachments to insurance
• Determine denial validity and properly address them
• Generate OI reports and ensure monthly completion
• Claim resubmission and reprocessing, including grievance and appeals
• Clear rejected claims on a weekly basis
• Update weekly office tracker to include all payments posted
• Generate EFT reports and retrieve EOBs from insurance portals for posting
• Identify any insurance process updates/issues and communicate findings with the team

Preferred Qualifications

• Highly motivated
• Detail-oriented
• Able to work independently

Benefits

• HMO with 1 free dependent upon hire (with Dental coverage)
• Life Insurance
• Night Shift/20% Night Differential
• 20 PTO credits annually
• Great Company Culture
• Career Growth and Learning
• Work from home