Dental Claim Benefit Specialist - Remote

Overview

The Dental Claim Benefit Specialist reviews and adjudicates routine dental claims in accordance with claim processing guidelines, ensuring accuracy and compliance.

In Short

• Review and adjudicate dental claims.
• Analyze and approve claims that cannot be auto adjudicated.
• Apply dental/medical necessity guidelines.
• Determine eligibility and coverage of benefits.
• Document claim information accurately.
• Communicate with healthcare providers and patients.
• Ensure compliance with regulatory requirements.
• Handle multiple assignments competently.
• Utilize personal computer and keyboard skills.
• Work in a production environment.

Requirements

• 1 year of Medical Claims processing or Customer Service experience.
• Strong analytical skills.
• Proficiency with Excel, Word, Teams, and Outlook.
• Ability to think logically and problem solve.
• High School diploma or equivalent G.E.D.

Benefits

• Affordable medical plan options.
• 401(k) plan with company contributions.
• Employee stock purchase plan.
• No-cost wellness programs.
• Tuition assistance.
• Flexible work schedules.
• Paid time off and family leave.
• Confidential counseling and financial coaching.
• Retiree medical access.
• Comprehensive benefits for employees and families.