[Hiring] Claims Analyst @Northeast Delta Dental

Role Description

Join Our Award-Winning Team at Northeast Delta Dental as a Dental Claims Analyst! Our Claims Edit Department in Concord, NH is seeking a full-time, remote, Claims Analyst to assure accurate adjudication, refunds, and adjustments of dental claims by reviewing, researching, and/or returning suspended dental claims in accordance with appropriate departmental processes.

The Dental Claims Analyst role offers a competitive hourly salary at $23.00 to $24.00 based on experience. Enjoy excellent benefits, including health, dental, vision, PTO, holidays, a 401(k), tuition reimbursement, and more!

Some of the Responsibilities for this Role:

• 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 benefits 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.

Qualifications

• 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.
• Ability to perform routine mathematical computations and calculations.

Requirements

• All Candidates must be authorized to work for any employer in the United States without sponsorship now and in the future.

Work Schedule

• The typical work schedule for this position is Monday - Friday, 8:00 a.m. - 4:00 p.m. for this 37.5 hour per week position.

Company Description

Northeast Delta Dental is proud to be an equal opportunity employer.