This is a Fully Remote Job
About Our Client:
The organization operates in the dental healthcare industry, focusing on providing patient-centered care since 1972. It addresses the challenge of delivering quality dental services through doctor-led practices equipped with advanced technology. The team emphasizes comprehensive training and community involvement to support local health initiatives.
About the Opportunity:
The CLAIMS SPECIALIST role is responsible for managing and resolving complex insurance claim issues to support doctors, practices, and revenue cycle teams. This position ensures timely claim processing and appeals, contributing directly to the organization's financial health and operational efficiency.
Responsibilities:
Proactively manage open insurance claims for prompt processing
Work aging reports to track unpaid claims
Collaborate with Insurance Specialists to resolve claim handling issues
Review payer explanation of benefits for contract compliance
Appeal and follow up on denied insurance claims
Identify and resolve payer denials
Provide additional information requested by payers
Resolve electronic claim rejections
Correct and resubmit claims in practice management systems and clearinghouses
Communicate effectively with doctors and team members to promote collaboration
Support a team environment based on trust, communication, and professional behavior
Pursue personal professional development through training and education
Adhere to organizational policies and service excellence standards
Represent the organization’s mission, vision, and values
Requirements:
Strong communication skills and ability to build cooperative relationships
High proficiency in interpreting various payers’ explanation of benefits
In-depth knowledge of coordination of benefits guidelines
Ability to manage multiple tasks independently with minimal supervision
Detail-oriented and well-organized
Self-motivated and able to work independently
Able to interact effectively across multiple locations and with diverse internal customers and patients
Minimum two-year associate degree required; bachelor’s degree preferred
Familiarity with dental and medical insurance claims
Experience communicating verbally and in writing with healthcare professionals and patients
Pay Range and Compensation Package:
Starting wage: $22-25 per hour
Benefits & Perks:
Medical, vision, and dental insurance
Paid time off and holiday pay
401(k) matching
Continuing education opportunities
Equal Opportunity Statement:
Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.
Note:
TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.