New York Licensed Claims Specialist
Job Summary
Detail-oriented and experienced, the fully remote New York Licensed Claims Specialist II will process dental claims, pre-authorizations, and referrals while ensuring compliance with service level agreements and regulatory guidelines.
Key responsibilities
- Process dental claims, pre-authorizations, referrals, and benefit determinations accurately and efficiently
- Review and adjudicate claims in accordance with plan guidelines, state regulations, and service level agreements
- Collaborate with internal teams to resolve claim-related issues and support operational goals
Required qualifications
- High School Diploma or GED
- Minimum one (1) year of dental claims processing experience
- Valid New York Adjuster License
- Experience processing claims, including Coordination of Benefits (COB) and Orthodontic claims
- Proficiency with Microsoft Office, including Excel, Outlook, and Word
Complete Job Description
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