Insurance Claims Processor

Elite Dental Partners•Chicago, IL

1d•$23 - $25

About The Position

The Insurance Claims Processor reviews and processes dental claims for assigned offices, ensuring claim details and required supporting documentation are accurate and complete. The role requires timely claim submission, resolution of claims within established timelines, and clear documentation of claim status and delays. The processor also handles complex or non-routine claims in partnership with Office Managers and Support Center Staff, and analyzes claim issues and payor payment cycles to support process improvements. Additional duties may be assigned.

Requirements

High school diploma.
At least 3 years of dental claims experience.
2–3 years of previous leadership experience.
Knowledge of Dentrix Core and Ascend PMS systems.
Microsoft Excel creation and basic functional working knowledge.
High attention to detail and accuracy.
Ability to meet set quota expectations.

Responsibilities

Review claims for accuracy of provider of service, claim billing address, dental codes as reflected in clinical notes, and patient information such as name, date of birth, and subscriber ID.
Identify procedures requiring attachments, such as X-rays, periodontal charting, and narratives, and ensure all required attachments are included before claims are sent.
Send all claims within 24 hours of the service date.
Ensure claims for assigned offices are resolved within 30 days.
Research, track, and clearly document claim status and reasons for delays in claim adjudication.
Analyze and interpret file notes and coverage documentation to respond to claim rejections or requests for additional information.
Handle difficult or non-routine claims and adjustment projects in partnership with Office Managers and Support Center Staff.
Analyze, track, and identify trends in claim issues and payor payment cycles to improve internal processes.
Perform other duties as assigned.