Dental Claims Processor & Adjustor

Firstsource; Louisville (KY); On-site; USD 48,000 - 62,000; Full time

Job summary

Delta Dental of Illinois is seeking a Claim Processor/Adjustor in the Claims department. You will process dental claims and troubleshoot inquiries, ensuring accuracy and adherence to business rules.

The role requires strong communication, attention to detail, and the ability to work independently, with a preference for bilingual Spanish candidates. Commitment to high attendance and quality service is expected.

Qualifications

• Excellent oral and written communications skills, strong keyboard skills, knowledge of reimbursement practices.
• Ability to work independently and multitask.
• Excellent attendance and punctuality.

Responsibilities

• Investigate and process claims according to established business rules that have failed computer program edits.
• Provide guidance in claims processing requiring advanced technical and dental knowledge.
• Meet daily/weekly claim production goals as set by the ITL.
• Complete and maintain daily audit production logs.
• Accurately completes special projects assigned within specified time frame.
• Access EPHI following current guidelines as established at company-wide and department levels.
• Maintain regular and punctual attendance.
• Perform other job-related duties as assigned.
• Update ITL or Manager regarding daily status of assigned reports by timeframe established by ITL or Manager.
• Encouraged to work overtime according to business need.
• Accesses EPHI following the current guidelines as established at the company-wide and department levels.
• Maintains regular attendance and punctuality.
• Performs other job-related duties as assigned.

Skills

Communication

Typing

Insurance knowledge

Independent work

Job description

Delta Dental of Illinois is seeking a Claim Processor/Adjustor in the Claims department. You will process dental claims and troubleshoot inquiries, ensuring accuracy and adherence to business rules.

The role requires strong communication, attention to detail, and the ability to work independently, with a preference for bilingual Spanish candidates. Commitment to high attendance and quality service is expected.