Dental Benefit Claim Technician – Remote

The Dental Claims Department is looking for a detail oriented and driven Dental Benefit Claim Technician. This role involves the thorough evaluation and adjudication of Dental Claims from notification through the claim’s duration. The Benefit Claim Tech is responsible for making initial claim determinations, ensuring accurate, timely decisions on benefits approval or denial, and communicating these decisions to claimants and employers. The role requires strong independent decision-making, critical thinking, and the ability to analyze eligibility, contracts, financials, and medical information while adhering to regulations. Effective communication with employers, claimants, and medical professionals is essential. The role directly impacts the financial success and customer retention of the organization.

The training hours for this position will be 7:30AM-4:00PM, CST for 6 weeks. Following training, you will be able to choose a shift between 6:00AM-6:00PM, CST.

WHAT WE CAN OFFER YOU:

Estimated Hourly Wage: $21.00, plus annual bonus opportunity.
Benefits and Perks, 401(k) plan with a 2% company contribution and 6% company match.
Regular associates working 40 hours a week can earn up to 15 days of vacation each year.
Regular associates receive 11 paid holidays in 2024, which includes 2 floating holidays that are added to your prorated personal time to be used at your discretion.
Regular associates are provided sick leave through the use of personal time. Associates working 40 hours a week can receive up to 40 hours of personal time in 2024, which is prorated based on the start date. Additionally you will receive two floating holidays in 2024 by way of personal time that may be used at your discretion.
Applicants for this position must not now, nor at any point in the future, require sponsorship for employment.
WHAT YOU’LL DO:

Demonstrates independent decision-making throughout the claim’s lifecycle, based on thorough evaluation and information gathering.
Develops claims files that reflect appropriate decisions using documented procedures, policy provisions, and customer expectations.
Maintains professional communication with claimants, brokers, employers, and internal partners, ensuring alignment with company values.
Accurately determines financial liability and eligibility, adhering to contract language, federal/state laws, and ERISA regulations.
Stays updated on industry changes, legislation, and internal processes, while providing clear explanations to claimants regarding determinations.
WHAT YOU’LL BRING:

Develops understanding of complex insurance provisions, regulations, and applies them to claims.
Analyzes vocational and medical information to make informed claims decisions and calculate benefits.
Communicates professionally with high customer service standards, both in writing and verbally.
Demonstrates strong organizational skills, attention to detail, and ability to work independently under deadlines.
Adapts to changing environments, manages tasks from dependence to independence, and escalates issues when necessary.
You promote a culture of diversity and inclusion, value different ideas and opinions, and listen courageously, remaining curious in all that you do.
Able to work remotely with access to a high-speed internet connection and in a listed location.
PREFERRED:

Previous dental claims experience
We value diverse experience, skills, and passion for innovation. If your experience aligns with the listed requirements, please apply!