Claims Examiner II
The Claims Examiner position is responsible for reviewing dental claims for accuracy and compliance with group and Delta processing guidelines and processing the minimum acceptable number of claims per day at or above the current acceptable accuracy or quality rates.
How you will make an impact:
- Review and adjudicate dental claims utilizing personal computer terminals in accordance with company and or regulatory guidelines.
- Route claims based on edit messages to the appropriate departments based on company and or regulatory guidelines.
- Perform miscellaneous duties as assigned.
What we look for:
- High School diploma or GED is preferred, but candidates with proven experience will not be excluded from consideration.
- Minimum of 2 years related experience preferred
- PC literacy required; MS Office skills (Outlook, Word, Excel and PowerPoint)
- Regularly required to work standard office equipment (personal computer, photocopy and fax machine, etc.)
- Analytical, problem solving and reasoning skills; detail orientation.
- Have good organizational or time management and multi-tasking abilities.
- Ability to work under pressure and meet deadlines.
- Ability to follow verbal and written instructions.
- Ability to effectively communicate problems, questions and explanations.
- Knowledge of Delta Dental systems or organization and knowledge of health care industry issues preferred.
Benefits and perks:
- 12 days starting vacation plus 11 holidays and your birthday off!
- Multiple medical insurance options: 100% paid or low cost premiums
- 100% paid dental insurance
- 100% paid vision insurance
- Onsite gym and/or gym discount and fitness incentive
- Culture of learning: substantial tuition reimbursement to improve your skills
- Career growth: we love promoting from within
- Strong commitment to work/life balance
- Technology allowance
- Social responsibility and volunteer opportunities
If you think this sounds like you, let’s chat. We would love to tell you more!
ABOUT Delta Dental
As the first company to specialize in dental insurance, we are passionate about oral health and its importance to future generations. Our core purpose is the advancement of oral health care to our customers, partners and consumers through dental insurance programs and philanthropic efforts.
We are part of the Delta Dental Plans Association, a network of companies that provides dental coverage to 74 million people in the U.S. Delta Dental of California, Delta Dental of New York, Inc., Delta Dental of Pennsylvania and Delta Dental Insurance Company, together with our affiliate companies, form one of the nation’s largest dental benefits delivery systems, covering 33 million enrollees. All of our companies are members, or affiliates of members, of the Delta Dental Plans Association, a network of 39 Delta Dental companies throughout the country.
Delta Dental provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Delta Dental complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.