Insurance Claims Processor

Elite Dental Partners•Chicago, IL

About The Position

The Insurance Claims Processor reviews and manages claims for assigned dental offices, ensuring claim information is accurate, required attachments are included, and claims are submitted and resolved on time. The role includes researching and documenting claim status, addressing rejections and requests for additional information, coordinating on complex claims, and analyzing claim issues and payer payment cycles to improve internal processes. The position requires dental claims experience, prior leadership experience, knowledge of Dentrix Core and Ascend PMS systems, and basic working knowledge of Microsoft Excel. The role involves sitting and typing for long periods. The stated hourly rate is $23–$25 USD.

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.
Basic functional working knowledge of Microsoft Excel.
High attention to detail and accuracy.
Ability to meet set quota expectations.

Responsibilities

Review claims for assigned offices for accuracy of provider of service, billing address, dental codes against clinical notes, and patient information.
Identify procedures requiring attachments, such as x-rays, periodontal charting, and narratives, and ensure required attachments are included before submission.
Ensure all claims are sent 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 adjudication.
Review file notes and coverage documentation to respond to claim rejections and 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 trend claim issues and payer payment cycles to improve internal processes.
Perform other duties as assigned.