Dental Benefits & Claims Inquiry Specialist

Wollborg Michelson Recruiting; Rancho Cordova (CA); On-site; USD 30,000 - 50,000; Full time

Job summary

Wollborg Michelson Recruiting is seeking a dental auditor/benefits specialist to handle complex beneficiary and provider inquiries, resolving issues, and processing related documents. The role requires knowledge of dental billing procedures, claims, and authorization processes, with the ability to navigate multiple computer systems and maintain confidentiality.

The ideal candidate has at least one year of communication experience, familiarity with dental terminology, and the ability to manage

Qualifications

• Pass the required dental auditor and X-ray reading tests.
• At least one year of communication experience.
• Knowledge of dental provider billing procedures and claims adjudication processes.
• Knowledge of applicable healthcare rules, dental codes, procedures, and practices is preferred.
• Knowledge of dental anatomy, physiology, pathology, and office terminology.
• Ability to perform detailed work, maintain confidentiality, and manage multiple concurrent tasks.

Responsibilities

• Research, resolve, and respond to complex telephone inquiries that cannot be answered immediately.
• Monitor cycle time reports and process documents, including customer information forms, notices of action, claims, treatment authorization requests, and related documents.
• Respond to beneficiary and representative inquiries regarding program policies, screening appointments, treatment authorization notifications, complaints, provider referrals, and available resources.
• Schedule and reschedule regional screening appointments as needed.
• Track beneficiary inquiries in the appropriate correspondence tracking system.
• Respond to provider office inquiries regarding program policies, claims and treatment authorization processing, explanations of benefits, payment inquiries, patient history, and enrollment status.
• Track provider inquiries in the appropriate correspondence tracking system.
• Complete additional projects and duties as assigned.

Skills

Customer service

Customer-focused communication

Telephone inquiry management

Research and problem-solving

Claims and authorization processing

Computer and multiple-systemNavigation

Detailed recordkeeping

Confidentiality and professionalism

Stress management and multitasking

Education

Dental assisting education

Job description

Wollborg Michelson Recruiting is seeking a dental auditor/benefits specialist to handle complex beneficiary and provider inquiries, resolving issues, and processing related documents. The role requires knowledge of dental billing procedures, claims, and authorization processes, with the ability to navigate multiple computer systems and maintain confidentiality.

The ideal candidate has at least one year of communication experience, familiarity with dental terminology, and the ability to manage