Dental Claims Specialist

Summary

Join our team as a Dental Claims Specialist and deliver exceptional service to our customers. Manage and process claims, resolve issues, and provide support while maintaining quality and integrity. You will follow up on outstanding insurance claims, ensuring proper documentation and communication. Responsibilities include sending claims and attachments, determining denial validity, generating reports, and resubmitting/reprocessing claims. You will also clear rejected claims, update trackers, generate EFT reports, post insurance payments, and identify process updates. Maintain professionalism, adhere to the schedule, and meet goals. This remote position requires strong communication skills and experience in dental insurance or collections.

Requirements

• Strong command of verbal and written English and interpersonal skills
• Little to no accent when speaking
• Background in the Dental insurance or collections industries
• 3+ years of hands-on collections experience
• Highly motivated, detail-oriented, able to work independently as this is a remote position
• Outstanding organizational, time management and follow-up skills

Responsibilities

• Follow-up status of outstanding insurance claims, make sure all follow-ups are properly documented and communicated by always adding a notation to the patient’s account (using the track stat and commlog)
• 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 (check scans and EFTs) and if all rejected claims were addressed
• Complete all follow-ups assigned (on the office spreadsheets)
• Generate EFT reports and retrieve EOBs from insurance portals for posting 100%
• Insurance payment posting - follow office preference, always upload EOB, and apply. correct adjustment/WO
• Identify any insurance process updates/issues and communicate findings with the team. that insurances are open while working
• Required to remain professional at all times, observing work ethics and adhering to the work time schedule
• Expected to hit the desired goal and accomplish all tasks in a timely manner
• Expected to communicate with the manager in the absence of any attendance issues

Benefits

• Salary: $4,500,000 COP
• Schedule: Monday to Friday - 8:00 AM to 5:00 PM EST
• Work Arrangement: WFM but must be based in Medellin
• Contract Type: Indefinite-term with full Colombian benefits