Claims Specialist I

Renaissance-Life-; Indianapolis (IN); Hybrid; USD 30,000 - 33,000; Full time

Job summary

Renaissance Benefits in Indianapolis, IN, is seeking a Dental Claims Specialist to analyze and adjudicate dental claims for accurate benefits administration. You will process claims per policies, contracts and state laws, review radiographs and chart notes, and handle manual entry for failed EDI transmissions.

The role requires a high school diploma or equivalent, with at least one year of dental insurance processing experience preferred and strong communication skills to interact with internal

Qualifications

• High school diploma or equivalent.
• Minimum one year dental insurance processing experience preferred.
• Ability to read and interpret radiographs, charts, and dental images.

Responsibilities

• Analyzes and adjudicates dental claims to determine benefits and processing determinations.
• Processes claims in accordance with policies, group contracts, provider agreements and state laws.
• Reviews radiographs and chart notes to ensure accurate processing of claims.
• Performs manual entry for claims that failed EDI transmission.

Skills

Dental terminology

Radiograph interpretation

Communication

Analytical thinking

Independent judgment

Education

High school diploma or equivalent

Tools

EDI systems

Job description

Job Title:Claims Specialist INumber of Positions:1Location:Indianapolis, INLocation Specifics:Hybrid PositionJob Summary:Renaissance Benefits is hiring for a Dental Claims Specialist!At Renaissance, the Dental Claims Specialist analyzes and adjudicates claims to ensure accurate benefits administration.What will this role entail?Accurately analyzes and processes dental claims so appropriate determinations can be finalized with correct procedures, policies, and bypasses.Administers claim processing guidelines/standards, Renaissance processing policies, group contracts, provider agreements, and state laws applicable to claims adjudication.Reviews all information submitted to ensure accurate processing of dental claims including interpretation of radiographs, periodontal charts, and chart notes.Reviews and prepares orthodontics and complex service claims for processing.Performs manual entry of claims that failed EDI transmission.Maintains related departmental documents and provides interpretation of processing guidelines to internal and external contacts.Other responsibilities as assigned by department Supervisor.Minimum Requirements:Hig h school diploma or equivalent; minimum of one year dental insurance processing experience is preferred; will accept other medical insurance experience.Knowledge of dental terminology and dental procedures and the ability to read and interpret radiographs, electronic images and photos.Effective verbal and written communication skills.Ability to resolve complex problems and use independent judgment.Will accept any suitable combination of education, training, or experience.Pay Range: $22.00-24.00/hourThe company will provide equal employment and advancement opportunity within the context of its unique business environment without regard to race, color, religion, gender, gender identity, gender expression, age, national origin, familial status, citizenship, genetic information, disability, sex, sexual orientation, marital status, pregnancy, height, weight, military status, or any other status protected under federal, state, or local law or ordinance.