Claims Specialist I

Renaissance Life & Health Insurance Company of America • Indianapolis, IN

3d • $22 - $24 • Hybrid

About The Position

Renaissance Benefits is hiring for a Dental Claims Specialist! At Renaissance, the Dental Claims Specialist analyzes and adjudicates claims to ensure accurate benefits administration.

Requirements

• High school diploma or equivalent
• Minimum of one year dental insurance processing experience is preferred; will accept other medical insurance experience.
• Knowledge of dental terminology and dental procedures
• Ability to read and interpret radiographs, electronic images and photos.
• Effective verbal and written communication skills.
• Ability to resolve complex problems and use independent judgment.
• Will accept any suitable combination of education, training, or experience.

Nice To Haves

• one year dental insurance processing experience is preferred

Responsibilities

• Accurately analyzes and processes dental claims so appropriate determinations can be finalized with correct procedures, policies, and bypasses.
• Administers claim processing guidelines/standards, Renaissance processing policies, group contracts, provider agreements, and state laws applicable to claims adjudication.
• Reviews all information submitted to ensure accurate processing of dental claims including interpretation of radiographs, periodontal charts, and chart notes.
• Reviews and prepares orthodontics and complex service claims for processing.
• Performs manual entry of claims that failed EDI transmission.
• Maintains related departmental documents and provides interpretation of processing guidelines to internal and external contacts.
• Other responsibilities as assigned by department Supervisor.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED