Dental Claims Approver II

This is a fully remote position, open to applicants in Pennsylvania.

📋 Description

• Manage the processing of dental claims that are entered via data, scanned, or submitted electronically.

• Evaluate and handle claims that cannot be automatically processed by the mainframe system.

• Implement state regulations when assessing initial claims and appeals.

• Consult with dental specialists to assess the necessity of treatments for claims.

• Investigate and address written appeals, inquiries, and complaints received.

• Follow up on claims that require further information or are pending within the system.

• Achieve and sustain productivity and quality objectives while working a standard 40-hour week.

• Be prepared to work overtime during busy periods as needed.

• Report directly to the Team Leader for Group Dental Claims.

⛳️ Requirements

• Capability to operate independently in a remote work setting.

• Ability to thrive under pressure in a role focused on production and quality.

• Proficient in interacting with both internal and external customers effectively.

• Strong skills in mathematics, analysis, organization, problem-solving, and relationship-building.

• Reliable with a strong attendance record.

• Openness to working overtime when needed.

• Excellent verbal and written communication abilities.

• Competent in PC navigation, including familiarity with mainframe systems.

• Capacity to make routine decisions using sound judgment.

• Legally permitted to work in the United States without the need for current or future employer sponsorship.

🏝️ Benefits

• Target annual bonus of 3%.

• Opportunities for skill enhancement.

• Leadership development prospects.

• Engagement in philanthropic initiatives.

• Access to modern, supportive, flexible, and inclusive benefits and resources for eligible full-time employees.