Claims Specialist

About the role

Responsible for providing support to doctors, practices, and Revenue Cycle teams with high-level insurance claim issue resolution.

Since 1972, Park Dental has been owned and led by our doctors who are passionate about providing the best patient-centered care. New team members receive comprehensive training and one-on-one mentoring to set you up for success. Our practices offer welcoming environments for patients, and are equipped with state of the art technology.

Responsibilities

• Proactively work open insurance claims to ensure prompt processing
• Work aging report to ensure unpaid claims have been received and are in process with payers
• Improve claim flow by working with Insurance Specialist to proactively identify and resolve claim handling issues
• Read and interpret payer explanation of benefits to verify claims adjudicated in accordance with contract guidelines
• Appeal and follow up on denied insurance claims as assigned
• Review, identify, and resolve payer denials
• Provide payers’ requested additional information to allow claim processing
• Resolve electronic claim rejections
• In practice management system, correct and resubmit claims stopped by our clearinghouse
• Correct and resubmit claims rejected by payer clearinghouse
• Effectively communicate and develop a strong working relationship with the