Dental Claims Processor

NationsBenefits India; Plantation (FL); Presencial; USD 42.000 - 64.000; Jornada completa

Descripción de la vacante

NationsBenefits India is seeking an experienced Dental Claims Processor to accurately review, adjudicate, and process dental insurance claims in a HIPAA-compliant environment. The role requires applying benefits, deductibles, maximums, and coordination of benefits while ensuring data accuracy.

Ideal candidates have 2+ years in dental/health claims processing, familiarity with CDT codes and EOBs, and proficiency in claims systems and Microsoft Office.

Formación

• 2+ years of dental or health insurance claims processing experience
• Knowledge of CDT codes, dental terminology, and EOBs
• Experience with claims adjudication systems
• Understanding of coordination of benefits (COB)
• Strong attention to detail and data accuracy
• Strong communication and customer service skills
• Proficiency with Microsoft Office and multiple claims systems

Responsabilidades

• Review and adjudicate dental claims
• Apply member benefits, deductibles, maximums, and coordination of benefits
• Process claim adjustments, reprocessing, and corrected claims
• Review claim documentation, narratives, and supporting records
• Research and resolve claims inquiries from providers, members, and internal teams
• Ensure compliance with HIPAA and company policies
• Meet productivity, quality, and turnaround time expectations

Conocimientos

Attention to detail

Communication skills

Customer service

Herramientas

Claims systems

Microsoft Office

Descripción del empleo

We are seeking an experienced Dental Claims Processor to support the accurate review, adjudication, and processing of dental insurance claims while ensuring compliance with plan benefits, regulatory requirements, and company policies.

Key Responsibilities:

• Review and adjudicate dental claims
• Apply member benefits, deductibles, maximums, and coordination of benefits
• Process claim adjustments, reprocessing, and corrected claims
• Review claim documentation, narratives, and supporting records
• Research and resolve claims inquiries from providers, members, and internal teams
• Ensure compliance with HIPAA and company policies
• Meet productivity, quality, and turnaround time expectations

Qualifications:

• 2+ years of dental or health insurance claims processing experience
• Knowledge of CDT codes, dental terminology, and EOBs
• Experience with claims adjudication systems
• Understanding of coordination of benefits (COB)
• Strong attention to detail and data accuracy
• Strong communication and customer service skills
• Proficiency with Microsoft Office and multiple claims systems

Preferred Qualifications:

• Experience with Medicare Advantage, Medicaid, or commercial dental plans