Claims Specialist I

Renaissance Life & Health Insurance Company of America; Indianapolis (IN); Hybrid; USD 30,000 - 33,000; Full time

Job summary

Renaissance Life & Health Insurance Company of America is seeking a Dental Claims Specialist I in Indianapolis, hybrid. You will analyze and adjudicate dental claims to ensure accurate benefits administration and compliance with guidelines.

Responsibilities include processing claims, reviewing radiographs and charts, and preparing complex service claims. Excellent communication and problem-solving skills are essential for success.

Qualifications

• High school diploma or equivalent; dental insurance processing experience preferred.
• Knowledge of dental terminology and procedures; read radiographs and related images.
• Effective verbal and written communication skills.
• Ability to resolve problems using independent judgment.

Responsibilities

• Analyzes and processes dental claims to determine proper benefits.
• Adheres to processing guidelines, contracts, provider agreements, and state laws.
• Reviews information to ensure accurate processing, including radiographs and charts.
• Prepares orthodontic and complex service claims for processing.
• Performs manual entry for claims that fail EDI transmission.
• Maintains department documents and communicates processing guidelines to others.
• Performs other duties as assigned by supervisor.

Skills

Dental terminology

Dental procedures

Radiographs interpretation

Communication skills

Education

High school diploma or equivalent

Job description

Job Title:

Claims Specialist I

Number of Positions:

1

Location:

Indianapolis, IN

Location Specifics:

Hybrid Position

Job 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:

• High 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/hour

The 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.