Claims Processing Representative I

Delta Dental Of Missouri • Saint Louis, MO

17h • Hybrid

About The Position

Delta Dental of Missouri is looking for a sharp, organized, and motivated Claims Processing Representative I to join our team. In this role, you'll independently process dental claims, investigate eligibility issues, and ensure accuracy across a variety of claim types. If you thrive in a fast-paced environment, love solving problems, and have a keen eye for detail—this is your opportunity to make an impact. Apply now to help us deliver accuracy and excellence in every claim. Position Summary: The primary responsibility of the Claims Processing Representative I is to independently process claims of low to moderate complexity. This role researches and investigates claims issues including eligibility denials, provider suspensions, and student eligibility decisions to completion when possible. This position resolves specialty claims or processes with low to moderate complexity and may leverage knowledge and skills to resolve complex claims in a single specialty or process area. This position may escalate complex claims issues to next level roles when needed.

Requirements

• Minimum of 3 years’ experience in the dental industry or claims processing role preferred
• Knowledge and experience in benefit determination and dental terminology preferred
• Strong verbal and written communication skills
• Detail-oriented with a commitment to accurate and efficient claims processing

Responsibilities

• Processes claims of low to moderate complexity across a variety of claims types.
• Resolves claims of low to high complexity across a single specialty or process area.
• Responds to emails, follows up and other forms of communication with other departments on outstanding claims issues requiring further intervention.
• Rotates through the assignment of Dailies on a regular basis.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed