Dental Appeals Claims Examiner

Job Summary

Dental Appeals Claims Examiner is a full-time position responsible for reviewing dental appeals, ensuring compliance with regulations, and making determinations within specified timeframes.

Key Responsibilities

• Analyze and process claims by investigating information and applying claim policies
• Interpret complex coverage contracts to assess eligibility
• Collaborate with various departments to gather necessary information for appeal decisions

Required Qualifications

• High School diploma or GED, or an Associate degree in lieu of required experience
• 3 - 5+ years of claims processing experience directly related to the role
• Experience in processing dental claims is preferred
• Ability to read and interpret dental policies
• Understanding of dental medical terms and records