Dental Claims Examiner
2 weeks ago
We are seeking a highly skilled Dental Service Analyst to join our team at Elevance Health. As a key member of our team, you will be responsible for performing utilization review of dental claims, ensuring consistent application of policy, departmental guidelines, and client contracts.
Key Responsibilities- Interpret radiographs, patient histories, and other records to make independent claim decisions regarding benefit eligibility.
- Request additional information as needed and hand off to dental consultants for medical necessity decisions.
- Provide expert analysis to dental Grievance and Appeals and Customer Service as requested.
- Participate in team efforts regarding process improvement and efficiencies.
To be successful in this role, you will need:
- A Bachelor's degree and a minimum of 2 years of experience in a clinical setting.
- A dental assistant certificate.
- Current licensure as a Dental Assistant or Dental Hygienist.
- Minimum of three years of experience in a clinical setting.
- Detailed knowledge of dental procedures and coding.
At Elevance Health, we offer a range of market-competitive total rewards, including merit increases, paid holidays, Paid Time Off, and incentive bonus programs. We also offer medical, dental, vision, short and long-term disability benefits, 401(k) + match, stock purchase plan, life insurance, wellness programs, and financial education resources.
We operate in a Hybrid Workforce Strategy, requiring associates to work at an Elevance Health location at least once per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
We are an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status or condition protected by applicable federal, state, or local laws.
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