Dental Claims Approver III

Job Responsibilities

• Scrutinizing dental claim documents & settlements
• Process claims as per the set healthcare guidelines
• Follow HIPAA guidelines
• Accurate processing of Dental claims and meeting productivity targets
• Good understanding of Claims adjudication fundamentals
• Good understanding of ICT & CPT Codes 
• Knowledge of policy concepts like Deductible, coinsurance, copay, out of pocket
• Able to learn, adapt, implement process guideline into practice, work as a natural team-player in the process
• Handle escalations
• Need to ensure quality and productivity targets are met
• Ensure compliance with internal policies and procedures, external regulations and information security standards