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Autumn Heights Dental
Dental Claims & Insurance Coordinator
Career Insights for Claims Processor
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Based on Texas data
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What they do
A Claims Processor reviews and processes insurance claims and determines whether an insurance policy will cover a claim. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a claim is approved.
$44,689 / year median in Texas
-2% projected decline
Job Description
AUM Dental Group is seeking an experienced and detail-oriented Dental Claims & Insurance Coordinator to join our team. We are looking for someone who understands the dental insurance process, takes initiative, follows through on outstanding claims, and can effectively communicate with insurance companies and our office teams. Responsibilities Submit and process dental insurance claims accurately and timely Follow up on outstanding and unpaid insurance claims Review insurance aging reports and work claims to resolution Research denied, rejected, or underpaid claims Review EOBs and identify payment discrepancies Submit corrected claims and appeals when necessary Follow up on insurance predeterminations and pre-authorizations Obtain and submit necessary narratives, x-rays, periodontal charting, and supporting documentation Contact insurance companies regarding claim status and payment issues Document all insurance follow-up and communication in the patient's account Work closely with front office staff, providers, and management to resolve insurance issues Verify insurance benefits when needed Maintain accurate and organized insurance records Assist with patient insurance questions when necessary Qualifications Dental insurance and claims experience required Knowledge of dental terminology and CDT procedure codes Experience with dental insurance billing, claims, denials, and appeals Familiarity with PPO dental insurance plans Experience using Open Dental is strongly preferred Ability to read and understand EOBs and insurance breakdowns Strong attention to detail and follow-through Excellent written and verbal communication skills Ability to work independently and manage multiple accounts Dependable, organized, and able to meet deadlines We are looking for someone who does more than simply submit claims. The ideal candidate will take ownership of the insurance process from submission through payment, proactively follow up on outstanding claims, identify problems, and work toward resolution. Accuracy, productivity, communication, and accountability are extremely important in this position.