Claims Specialist I

Renaissance Life & Health Ins Co of Am; Indianapolis (IN); Hybrid; USD 30,000 - 33,000; Full time

Job summary

Renaissance Benefits is seeking a Dental Claims Specialist to analyze and adjudicate dental claims for accurate benefits administration.

The role involves applying guidelines, reviewing radiographs and chart notes, and preparing complex service claims for processing in a hybrid Indianapolis setting. Prior dental insurance processing experience is preferred; high school diploma required.

Qualifications

• High school diploma or equivalent required.
• Minimum of one year dental insurance processing experience preferred.
• Knowledge of dental terminology and the ability to read radiographs, electronic images and photos.

Responsibilities

• Accurately analyzes and processes dental claims for correct determinations.
• Applies processing guidelines, policies, contracts, and state laws to adjudication.
• Reviews radiographs and chart notes to ensure accurate processing of dental claims.

Skills

Verbal and written communication

Dental terminology

Problem solving

Independent judgment

Education

High school diploma or equivalent

Job description

Job Title: Claims Specialist I

Number of Positions: 1

Location: Indianapolis, IN - 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.

Renaissance Life & Health Insurance Company of America and its sister company Renaissance Life & Health Insurance Company of New York, offer supplemental health and ancillary benefits for employer groups and individuals nationwide. RenSecureHealth, a modern supplemental health offering, as well as dental, vision, life and disability insurance comprise the core line of the company’s ancillary benefits solutions.

With headquarters in Indianapolis, Indiana, Renaissance is focused on providing its members and partners with outstanding products and services.

Visit www.renaissancebenefits.com and find us on Facebook, LinkedIn and Twitter.