Kansas Licensed Dental Benefits Specialist

Job Summary

The full-time remote Kansas Licensed Dental Benefits Specialist will manage second-level appeal documentation, coordinate clinical reviews between third-party administrators and vendors, and conduct post-payment claims audits while serving as an internal dental subject matter expert.

Key responsibilities

• Ensure accuracy and completeness of second-level appeal documentation and manage clinical review processes
• Conduct post-payment claims audits to identify overpayments and billing errors while preparing detailed audit findings reports
• Provide expert guidance on dental benefit interpretation, coding, and claims accuracy to internal teams and external partners

Required qualifications

• Associate's or Bachelor's degree in Dental Hygiene, Health Administration, or a related field preferred
• Minimum of 5 years of experience in dental claims review or dental benefits administration
• Dental clinical training, certification, or licensure (RDH or equivalent) strongly preferred
• Advanced expertise in dental benefit administration and CDT coding
• Experience conducting claim audits and coordinating clinical reviews in a dental insurance setting