Claims Specialist

Overview

Position Purpose:

Responsible for providing support to doctors, practices, and Revenue Cycle teams with high-level insurance claim issue resolution.

Starting Wage: $22-25 per hour

Responsibilities

Essential Job Duties:

• Proactively work open insurance claims to ensure prompt processing
• Work aging report to ensure unpaid claims have been received and are in process with payers
• Improve claim flow by working with Insurance Specialist to proactively identify and resolve claim handling issues
• Read and interpret payer explanation of benefits to verify claims adjudicated in accordance with contract guidelines
• Appeal and follow up on denied insurance claims as assigned
• Review, identify, and resolve payer denials
• Provide payers’ requested additional information to allow claim processing

· Resolve electronic claim rejections

• In practice management system, correct and resubmit claims stopped by our clearinghouse
• Correct and resubmit claims rejected by payer clearinghouse
• Personal and Professional Responsibilities:
• Effectively communicate and develop a strong working relationship with the Doctors and all Team Members and promote teamwork through cooperative and professional behaviors
• Create an environment which promotes trust, open communication, creative thinking, and team collaboration
• Assume responsibility for personal professional growth through internal and external training opportunities and continuing education offerings
• Follow and demonstrate commitment to the Park Dental policies, professional expectations, and Service Excellence Standards
• Serve as an example and representative of the organization by demonstrating behaviors consistent with Park Dental and The Dental Specialists Mission, Vision, and Values

Tools and Technology:

• Practice Management, dental EDI experience and knowledge

· Claims and/or dental familiarity

• Proven systems aptitude and strong MS Office skills (Excel, Access and Word).
• Familiarity with insurance company website
• A quick study of new systems and software tools and a willingness to embrace technology to improve productivity

Required Skills/Qualifications:

• Possess strong communication skills and the ability to develop constructive and cooperative working relationships with others, striving for collaboration and demonstrating professionalism
• High skill level of interpreting a variety of payers’ explanation of benefits
• Understands coordination of benefits guidelines in depth
• Ability to manage multiple activities simultaneously with minimal direction, while relying on experience and judgment to plan and accomplish goals

· Detail oriented and well-organized

• Self-motivated and the ability to work independently
• Able to effectively deal with multiple locations, variety of internal customers, and patient situations

Education and Knowledge:

• Minimum two-year associates degree, bachelor’s degree preferred
• Familiarity with Dental and Medical insurance claims
• Experience with verbal and written communication to healthcare professionals and patients

Work Schedule

Monday through Friday 8am-5pm (hours are flexible)

• Position is remote! Applicants must currently reside in Minnesota, Arizona, or Wisconsin to be considered for this role.*

Company Information

Benefits

Park Dental offers competitive compensation, and generous benefits package including medical, vision, dental, PTO, holiday pay, 401k matching, and continuing education opportunities.

Community

Park Dental values being involved in the community through volunteer events, such as Minnesota Dental Association's Give Kids a Smile Day, the American Heart Association Heart Walk, and Minnesota Mission of Mercy. Each practice participates in events in their local communities too!

About Park Dental

Since 1972, Park Dental has been owned and led by our doctors who are passionate about providing the best patient-centered care. New team members receive comprehensive training and one-on-one mentoring to set you up for success. Our practices offer welcoming environments for patients, and are equipped with state of the art technology.

"As a dental hygienist with Park Dental, we have the opportunity to engage patients in the process of improving and maintaining their oral health, which in turn leads to over-all health." -Berit Campbell, DH Mentor

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Park Dental is an equal opportunity employer.

Originally posted on Himalayas