Claims Processor

Top Job

Located in Tampa, FL

Salary: 16-20 Hourly

We’re looking for a sharp, detail-driven pro who knows dental billing and claims inside and out—and wants a stable role with a great team.  In this role, you’ll review and process dental and benefit claims, assist callers with questions about their benefits, and help ensure our clients and providers receive accurate and timely service. 

What you’ll do:

• • Review and adjudicate dental and benefits claims according to policy and contract requirements
  • Request additional information by phone, email, or letters when needed
  • Determine claim outcomes within established guidelines and timelines
  • Research and resolve claim issues; escalate complex cases to the appropriate department
  • Take inbound calls from clients, members, and providers and provide first-call resolution whenever possible
  • Clearly explain benefits, claim decisions, and next steps to callers
  • Use multiple software systems and tools to research and document accounts
  • Meet performance expectations for accuracy, productivity, quality, and turnaround time
  • Participate in ongoing training and adapt to new technologies, policies, and processes

Requirements: 

• 1-2 years of experience with Dental Billing or Dental Claims Payment
• Experience with COBRA Administration
• Experience with administration of Flex Spending Account and Health Savings Account
• Dental industry experience (front office, insurance coordination, claims)
• Experience in benefits claims and/or consumer-driven health plans
• Previous customer service or call center experience, especially in healthcare or insurance

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