Claims Specialist

• Follow-up status of outstanding insurance claims, make sure all follow-ups are properly documented and communicated by always adding a notation to the patient’s account (using the track stat and commlog)
• Send out claims and attachments to insurance
• Determine denial validity and properly address them
• Generate OI reports and ensure monthly completion
• Claim resubmission and reprocessing, including grievance and appeals
• Clear rejected claims on a weekly basis
• Update weekly office tracker to include all payments posted (check scans and EFTs) and if all rejected claims were addressed
• Complete all follow-ups assigned (on the office spreadsheets)
• Generate EFT reports and retrieve EOBs from insurance portals for posting 100%
• Insurance payment posting - follow office preference, always upload EOB, and apply correct adjustment/WO
• Identify insurance process updates/issues and communicate findings with the team
• Remain professional, observe work ethics, and adhere to the work time schedule
• Hit desired goals and accomplish tasks in a timely manner
• Communicate with the manager regarding attendance issues

Explore Dental Claims Specialist at SuperStaff. Review requirements and application details.