Jr Dental Claims Coordinator

Astiva Health, Inc; California (MO); On-site; USD 40,000 - 55,000; Full time

Job summary

Astiva Health, Inc. is currently seeking a Junior Dental Coordinator based in California, MO. The ideal candidate will support dental claims processing, assist providers with claim submissions, and help members with dental inquiries. Candidates should have familiarity with CDT codes and experience with dental management systems.

The role involves ensuring accurate claims adjudication, tracking documentation, and providing excellent service to providers and members alike.

Qualifications

• Familiarity with dental documentation requirements and prior authorizations.
• Experience preferred with payer portals or dental practice management systems.
• Strong organizational and communication skills.

Responsibilities

• Process and review dental claims for completeness and accuracy.
• Assist providers in submitting clean claims.
• Adjudicate member direct reimbursement.

Skills

Familiarity with CDT codes

Strong organizational skills

Communication skills

Detail-oriented

Tools

Dental practice management systems

Payer portals

Job description

Astiva Health, Inc., located in Orange, CA is a premier healthcare provider specializing in Medicare and HMO services. With a focus on delivering comprehensive care tailored to the needs of our diverse community, we prioritize accessibility, affordability, and quality in all aspects of our services. Join us in our mission to transform healthcare delivery and make a meaningful difference in the lives of our members.

SUMMARY

The Junior Dental Coordinator role assists with dental claims processing, provider support, and authorization review to ensure accurate and timely adjudication. This position reviews claims for completeness, follows up on required documentation, supports providers with portal use and clean submissions, and helps identify and resolve issues prior to formal review. The role also supports member services with dental-related inquiries and reimbursements, escalating complex cases as needed.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Dental Claims Operations Support

• Process and review dental paper claims for completeness and accuracy
• Request missing documentation (e.g., X-rays, narratives, periodontal charting) to ensure timely claims adjudication
• Track and follow up on outstanding documentation to meet regulatory turnaround timelines

Provider Relations Support

• Assist dental providers and office staff on proper use of the Astiva Health online portal
• Assist providers in submitting clean claims and complete authorization requests
• Assist PR staff with common dental claims and portal-related questions
• Preview dental prior authorization submissions on the provider portal
• Identify missing documentation or administrative deficiencies prior to formal review
• Flag incomplete or non-compliant submissions to reduce delays and denials
• Escalate complex or high dollar claims to senior coordinators

Member Services Support

• Assist MS team with dental related issues
• Adjudicate member direct reimbursement and escalate complex, high dollar cases to senior coordinators

EDUCATION AND/OR EXPERIENCE

• Familiarity with CDT codes, dental documentation requirements, and dental prior authorizations
• Experience working with payer portals or dental practice management systems experience preferred
• Strong organizational, communication, and follow-up skills
• Detail-oriented with ability to identify trends and discrepancies
• Medicare Advantage or managed care experience a plus