Dental Claims Processor

Dental Claims Processor

Location: Plantation, FL

Employment Type: Full-Time

We are seeking an experienced Dental Claims Processor to support the accurate review, adjudication, and processing of dental insurance claims while ensuring compliance with plan benefits, regulatory requirements, and company policies.

Key Responsibilities:

• Review and adjudicate dental claims
• Apply member benefits, deductibles, maximums, and coordination of benefits
• Process claim adjustments, reprocessing, and corrected claims
• Review claim documentation, narratives, and supporting records
• Research and resolve claims inquiries from providers, members, and internal teams
• Ensure compliance with HIPAA and company policies
• Meet productivity, quality, and turnaround time expectations

Qualifications:

• 2+ years of dental or health insurance claims processing experience
• Knowledge of CDT codes, dental terminology, and EOBs
• Experience with claims adjudication systems
• Understanding of coordination of benefits (COB)
• Strong attention to detail and data accuracy
• Strong communication and customer service skills
• Proficiency with Microsoft Office and multiple claims systems

Preferred Qualifications:

• Experience with Medicare Advantage, Medicaid, or commercial dental plans
• Prior dental insurance or utilization review experience
• Bilingual English/Spanish

If you're looking to grow your career in healthcare and dental claims operations, we'd love to hear from you.

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