Claims Coordinator

OrthoFi Inc.; Denver, Northern (CO, KY); Hybrid; USD 23,000 - 28,000; Full time

Benefits offered by this job

Medical, dental, and vision benefits

Flexible PTO

HSA contribution

9 company paid holidays

401(k) match

Job summary

OrthoFi, headquartered in Denver, CO, is seeking a Claims Coordinator to support end-to-end orthodontic claims processing. You will submit claims, address denials, and research missing payments while building expertise across claims operations.

Ideal candidates have 2+ years in dental insurance/claims, strong analytical and communication skills, and comfort with platforms like sFax, Adobe, PureCloud, and JIRA. Optional work-from-home flexibility is offered.

Qualifications

• 2+ years of hands-on experience navigating dental insurance plans (DPPO, PPO, DHMO)
• 2+ years of hands-on experience processing dental/orthodontic claims
• Knowledge of dental revenue cycles and carriers

Responsibilities

• Submit orthodontic claims and resolve denials
• Research missing payments and process adjustments
• Audit accounts and manage escalation cases
• Track and recover missing payments
• Collaborate across OrthoFi departments to optimize workflow

Skills

Dental claims experience

Dental revenue cycles

Carrier liaison

Analytical/problem-solving

Communication skills

MS Office/Google Docs

Tech proficiency (sFax, Adobe, PureCl

Tools

sFax

Adobe

PureCloud

JIRA

Job description

At OrthoFi, we're not just another player in the orthodontic industry – we're the driving force that helps orthodontists launch more smiles while ensuring top-tier patient care. Our tech-savvy solutions are the secret sauce that empowers orthodontic practices across the United States. With a track record of supporting over 2,000 practices, and in partnership with OrthoBanc, we've unlocked access to quality, affordable orthodontic care for a whopping 3.2 million patients and counting!

Picture this: Our cutting-edge Patient Acquisition software combined with our expert Revenue Cycle Management solutions propels practices to achieve jaw-dropping 13% year-over-year growth. Plus, when it comes to patient and insurance billing, our collection results leave competitors in the dust.

Behind our mission is a dynamic team of around 300 passionate individuals. Our headquarters is based in Denver, CO, with employees spread across several states. Join us in our quest to transform the orthodontic landscape – where innovation meets dedication, and starting more smiles are just the beginning.

Our purpose is to radically improve the way patients access and pay for quality elective care. Diversity, equity, and inclusion (DEI) ensures we can fulfill our purpose by creating a better, more equitable and inclusive workplace for our community members and healthcare experience for all.

By focusing on DEI, we are working towards our mission of connecting more patients with quality orthodontic and dental care and helping make treatment accessible to over 1 million patients a year by 2025 . Equity is core to our mission to serve patients, and DEI is embedded in our core values, especially “seek diversity,” and “do what’s right.”

OrthoFi is proud to be an equal opportunity workplace and is an affirmative action employer. We are committed to equal employment opportunities regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status.

Roles based outside of our Denver office can sit in any of the following states: Colorado, Florida, Georgia, Louisiana, North Carolina, Ohio, Tennessee, and Texas.

About the Role:

As a Claims Coordinator, you’ll support the end-to-end claims process by submitting orthodontic claims, resolving denials, researching missing payments, and processing adjustments accurately and efficiently. Over time, you’ll develop broad expertise across all areas of claims operations and become a key resource within the department.

This role is ideal for someone with experience in dental, orthodontic, or revenue cycle management who is passionate about delivering a strong experience for both patients and practices while ensuring claims are processed accurately and effectively.

What You Will Do:

• Streamlined Processing: Ensure claims accuracy and timely submission, minimizing disruptions for patients and practices.
• Issue Resolution: Address rejected or denied claims promptly, resolving challenges with finesse and professionalism.
• Account Integrity: Conduct thorough audits and manage escalation cases, safeguarding the integrity of every account.
• Financial Recovery: Track and recover missing payments efficiently, optimizing revenue streams for our practices.
• Technological Mastery: Utilize cutting-edge platforms like sFax, Adobe, PureCloud, and JIRA with proficiency, enhancing workflow efficiency and collaboration.
• Professional Growth: Take ownership of your development journey, embracing opportunities for advancement and skill enhancement.
• Cross-Functional Collaboration: Foster strong relationships across OrthoFi departments, understanding their functions and enhancing synergy for maximum impact.

What You Will Bring:

• 2+ years of hands-on experience navigating the intricate landscape of dental insurance plans , including DPPO, PPO's, and DHMO's, demonstrating your mastery of the nuances within each.
• A proven track record with over 2 years of hands-on experience processing dental/orthodontic claims , showcasing your adeptness at managing and expediting claims processes efficiently.
• In-depth knowledge and familiarity with dental revenue cycles , enabling you to optimize processes and maximize revenue streams effectively.
• Experience and fluency in liaising with multiple insurance carriers , demonstrating your ability to adapt and excel in diverse environments.
• A knack for making sound judgments and decisions , coupled with analytical prowess and problem-solving skills that set you apart from the rest.
• Exceptional communication skills , not just in writing and verbal expression, but also in active listening, ensuring clear understanding and effective collaboration.
• Proficiency with Microsoft Office and/or Google Documents , essential tools in today's digital workspace.
• A hunger for learning and a knack for swiftly mastering business-related software systems , enabling you to adapt to evolving technologies and processes seamlessly.

What’s in it for you:

• Full medical, dental, and vision benefits
• Flexible PTO
• Employer HSA contribution
• 9 Company Paid holidays
• 401(k) match, 3% after 90 days of employment
• Supportive culture with one-of-a-kind growth opportunities
• Option to work from home
• Paid Parental Leave as well as a two-week "ease-back" program that enables parents to return part-time at full pay
• Company and team outings

Compensation: $17.50/hour

** Please note that the compensation information that follows is a good faith estimate for Colorado-based hires only and is provided with the Colorado Equal Pay for Equal Work Act and Equal Pay Transparency Rules.**

Work Authorization:You must be authorized to work in the United States. The Company is unable to provide sponsorship for workers.