Dental Claims Processor I

$35,360 - $42,390/Yr

Moda Health - Milwaukie, OR

Full-time - Entry Level

Hybrid - Milwaukie, OR

Insurance Carriers and Related Activities

About the position

The Dental Claims Processor I position at Moda Health involves reviewing and processing dental claims that did not auto-adjudicate. The role requires making necessary corrections and ensuring claims are processed according to established policies and contract provisions. This is a full-time hybrid position based in Milwaukie, OR, offering a pay range of $17.00 to $20.38 per hour, depending on experience.

Responsibilities

• Review claims to determine the reason for non-auto-adjudication.
• Make corrections as necessary and process claims according to policies and contract provisions.
• Use contract notes and processing manuals to apply correct benefits to pended claims.
• Document claims processing clearly and concisely.
• Analyze pended claims to determine why they did not auto-adjudicate.
• Send clinical requests and missing information letters.
• Perform manual calculations of benefits as needed.
• Interact professionally with co-workers and supervisors.

Requirements

• High school diploma or equivalent.
• 10-key proficiency of 105 kspm net on a computer numeric keypad.
• Typing speed of a minimum of 35 wpm net on a computer keyboard.
• Ability to achieve and maintain quality and quantity standards.
• Possess legible handwriting.
• Knowledge of dental terminology and ADA codes preferred.
• Data entry experience dealing with various plans/claims preferred.
• Good reading, verbal, and written communication skills.
• Analytical, problem-solving, and decision-making skills.
• Detail-oriented with good memory retention and ability to shift priorities.
• Good organizational skills and ability to work well under pressure.

Nice-to-haves

• Knowledge of dental terminology and ADA codes.
• Data entry experience with various plans/claims.

Benefits

• Medical, Dental, Vision, Pharmacy, Life, & Disability insurance
• 401K with matching
• Flexible Spending Account (FSA)
• Employee Assistance Program
• Paid Time Off (PTO) and Company Paid Holidays