Claims Specialist I

Renaissance Benefits is hiring for a Dental Claims Specialist in a hybrid role based in Indianapolis, IN.

About the role

The Dental Claims Specialist analyzes and adjudicates claims to ensure accurate benefits administration.

Responsibilities

• Accurately analyze and process dental claims to finalize determinations with correct procedures, policies, and bypasses.
• Administer claim processing guidelines, Renaissance policies, group contracts, provider agreements, and applicable state laws.
• Review all submitted information to ensure accurate processing of dental claims, including interpretation of radiographs, periodontal charts, and chart notes.
• Review and prepare orthodontics and complex service claims for processing.
• Perform manual entry of claims that failed EDI transmission.
• Maintain related departmental documents and provide interpretation of processing guidelines to internal and external contacts.
• Other responsibilities as assigned by department Supervisor.

Requirements

• High school diploma or equivalent.
• Minimum of one year dental insurance processing experience is preferred; other medical insurance experience may be accepted.
• Knowledge of dental terminology and dental procedures.
• Ability to read and interpret radiographs, electronic images, and photos.
• Effective verbal and written communication skills.
• Ability to resolve complex problems and use independent judgment.
• Any suitable combination of education, training, or experience will be considered.

Pay

$22.00–$24.00/hour