Claims Analyst ~ Dental Insurance

Northeast Delta Dental•Concord, NH

14h•Onsite

About The Position

Northeast Delta Dental, named one of the 2025 Best Companies to Work For in New Hampshire, is seeking a full-time Dental Claims Analyst for their Claims Edit Department in Concord, NH. This role offers competitive pay, outstanding benefits, workplace flexibility, and career growth opportunities. The primary responsibility of the Claims Analyst is to ensure accurate adjudication, refunds, and adjustments of dental claims by reviewing, researching, and/or returning suspended dental claims in accordance with departmental processes. The position offers an hourly salary of $23.00 to $24.00 based on experience, along with excellent benefits including health, dental, vision, PTO, holidays, a 401(k), and tuition reimbursement.

Requirements

At least two years claims processing or insurance related experience, or an equivalent combination of training, experience, and/or education.
Must be proficient in Microsoft Excel and Word.
Must possess thorough knowledge of CDT coding and dental terminology and be able to perform routine mathematical computations and calculations.

Responsibilities

Adjudicates claims using Northeast Delta Dental and New England Dental Administrators, LLC, processing policies by reviewing, correcting, editing, and researching suspended claims; contacts dental offices, as necessary, to obtain routine missing information or to correct information.
Researches, corrects and processes claims queries.
Processes claims requiring special handling, special consideration, and manual pricing by following the applicable processes noted in the department manual outlined for specific programs/groups/benefits (for example, Ortho, Head Start, Exchanges, New England Dental Administrators, LLC).
Resolves Dental Coordination of Benefits (COB), Dual Delta, and medical claims based on coordination of benefits guidelines; ensures the accuracy of benefit s allocation between primary and secondary dental and medical carriers.
Calculates refunds for the Customer Service staff, verifies coordination of benefits resolutions and provides information to questions about claims payments.
Assures appropriate documentation, X-rays, and/or any applicable notes are attached before forwarding claims to consultant review by reviewing claims and returning claims missing information to the dental offices.