Remote Senior Dental Benefits Specialist

GEHA; Kansas; Hybrid; USD 63,000 - 80,000; Full time

Benefits offered by this job

Health benefits

401(k) matching

Tuition assistance

Hybrid/remote options

Job summary

GEHA is seeking a Senior Dental Benefits Specialist to lead second-level appeal documentation and clinical review coordination between the TPA and vendor. You will ensure audit-ready records and defendability of determinations within a federally regulated dental program.

This senior contributor role requires extensive experience in dental claims, CDT coding, and benefit interpretation. Hybrid/remote work options are available with competitive pay and benefits.

Qualifications

• Associate’s or Bachelor’s degree in Dental Hygiene, Health Administration, or related field preferred.
• Minimum 5 years of experience in dental claims review, benefits administration, or appeals processing.
• Strong CDT coding knowledge and claims adjudication experience.
• Excellent written communication with audit findings documentation.

Responsibilities

• Own second-level appeal documentation and clinical review workflow.
• Coordinate between TPA and clinical review vendor with case summaries.
• Conduct post-payment dental claims audits and identify improper payments.
• Serve as dental SME for benefit interpretation and CDT coding.

Skills

Dental benefits administration

CDT coding

Claims adjudication

Audit findings

Written communication

Education

Associate’s degree in Dental Hygiene

Bachelor’s degree in Health Administration

Tools

Microsoft Office

Job description

GEHA is seeking a Senior Dental Benefits Specialist to lead second-level appeal documentation and clinical review coordination between the TPA and vendor. You will ensure audit-ready records and defendability of determinations within a federally regulated dental program.

This senior contributor role requires extensive experience in dental claims, CDT coding, and benefit interpretation. Hybrid/remote work options are available with competitive pay and benefits.