Remote Jobs
Dental Claims Review Analyst - Remote
What's your preference?
Job Description
- Req#: 1000002532
Employer Industry: Dental Insurance Services
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Utilize specialized knowledge to make a significant impact on claims processing efficiency
- Engage in provider outreach to facilitate claim resolution
- Chance to work closely with dental consultants and directors on escalated claims
What to Expect (Job Responsibilities):
- Analyze and process suspended claims, predetermination, and service requests based on clinical guidelines
- Perform provider outreach and collaborate with dental consultants for claim resolution
- Investigate member benefits and policies related to claims and grievances
- Identify potential fraud patterns and escalate issues to the appropriate teams
- Recommend improvements to enhance system efficiency for dental claims processing
What is Required (Qualifications):
- Certification as a Dental Hygienist or in Claims Coding
- 2-3+ years of relevant experience, including a clinical dental environment
- Knowledge of claim processing policies and procedures
- Proficient in MS Office Suite (Word, Excel, PowerPoint, Outlook, Teams)
- Strong verbal, written, presentation, and interpersonal communication skills
How to Stand Out (Preferred Qualifications):
- Bachelor's Degree in a related field
- Additional specialized training or certifications that may substitute for a Bachelor's degree
- Experience in analyzing dental claim coding issues
#DentalInsurance #ClaimsProcessing #CareerGrowth #ProviderOutreach #FraudDetection
We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.
We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
The best remote jobs for you
Notice
Talentify is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Talentify provides reasonable accommodations to qualified applicants with disabilities, including disabled veterans. Request assistance at accessibility@talentify.io or 407-000-0000.
Federal law requires every new hire to complete Form I-9 and present proof of identity and U.S. work eligibility.
An Automated Employment Decision Tool (AEDT) will score your job-related skills and responses. Bias-audit & data-use details: www.talentify.io/bias-audit-report. NYC applicants may request an alternative process or accommodation at aedt@talentify.io or 407-000-0000.