State Licensed Dental Claims Examiner

Job Summary

A company is looking for a Sr Dental Claims Examiner to utilize clinical knowledge of dentistry for dental claims processing.

Key Responsibilities

• Perform initial screening for dental claims requiring utilization review according to clinical criteria
• Serve as a liaison between the customer service/claims department and dental consultants for claims that do not meet clinical criteria
• Evaluate claim discrepancies and ensure accurate processing while resolving inquiries and problems

Required Qualifications

• Post-secondary training or two years clinical experience as a Dental Assistant or Dental Hygienist
• Completion of Radiology Training
• 1-3 years of Dental Assistant, Hygienist, or related clinical experience
• Insurance industry experience preferred