What are the responsibilities and job description for the Dental Claim Processor position at E.D.I.S.?
We are seeking an experienced and enthusiastic Dental Claim Processor to join our team. In this role, you will process claims for a third party administrator and determine benefit allocations by reviewing the plan design and schedule of benefits. You will review carrier and provider information to determine correct payment. Also you will use previous claim processing experience to interpret and understand unusual plan designs, while maintaining high quality levels.
Responsibilities
- Processes claims in accordance with employer benefit plan.
- Meets or exceeds established goals in relation to productivity and quality metrics.
- Completes written communication with outside parties as needed to explain benefit payments and denials.
- Researches carrier documents to ensure claim payments are accurate.
- Works with Customer Service, Benefit Loading and other areas to improve processes and workflows.
- Works with the IT department to ensure system processes work correctly.
- Follows and adheres to all policies, procedures, and practices to enhance claim productivity and quality.
- Demonstrates ability to help team members with complex issues, adjustments and special projects.
Competencies:
- Excellent Organizational skills
- Ability to work independently
- Time management ability with focus on prioritizing tasks.
- Detail orientation with experience in analyzing data.
- Proven interpersonal skills to interact with other areas.
- Proficiency in office software applications (e.g., Microsoft Office Suite).
Required Skills:
- Dental claim processing, two year's experience preferred
- Knowledge of carrier benefit plans and processes.
Join us in making a difference by providing exceptional service to our valued customers!
Pay: $17.00 - $18.00 per hour
Benefits:
- 401(k)
- Health insurance
- Paid time off
- Vision insurance
- Work from home
Application Question(s):
- Are you able to work in the office during training and transition to remote after completion?
Experience:
- dental claim processing: 2 years (Preferred)
Work Location: Hybrid remote in Visalia, CA 93291
Salary : $17 - $18