Dental Claims Analyst

Job Summary

A company is looking for a Dental Claims Review Analyst - Remote.

Key Responsibilities

• Review and analyze claims and pre-determinations using clinical expertise and industry guidelines
• Perform provider outreach and investigate member benefits for claims and grievance cases
• Identify potential claims problems or fraud patterns and refer to appropriate personnel

Required Qualifications

• Bachelor's Degree (Preferred)
• Certification as Dental Hygienist or Claims Coding (Required)
• 2-3+ years of related experience in a clinical dental environment (Required)
• Knowledge of claim processing policies and procedures (Required)
• Proficient with MS Office applications (Required)