Senior Dental Claims Examiner

Job Summary

Working remotely, the full-time Senior Dental Appeals Claims Examiner will independently review denied dental claim appeals, ensuring accurate and compliant decisions while collaborating with various stakeholders to enhance customer experience.

Key responsibilities

• Analyze and process claims by investigating information and applying claim policies and procedures
• Evaluate complex coverage contracts to determine eligibility and communicate outcomes to customers
• Collaborate with internal teams to clarify issues and improve overall claims workflow and customer experience

Required qualifications

• High School diploma or GED, or minimum Associate degree in lieu of required experience
• 3 - 5+ years of dental claims processing experience directly aligned to the specific responsibilities for this role
• Understanding of dental medical terms, records, and test results
• Ability to read, analyze, and interpret dental policies
• Demonstrated strong organizational skills with the ability to prioritize workload and multi-task