Insurance Claims Specialist

At Risas Dental and Braces, our focus is providing quality and affordable dental care and braces for families everywhere. Our goal is to think and speak a language that patients understand. For this reason, our Company Statement is We Speak Patient™. The result is happier, healthier Patients, and better opportunities for our doctors and team members.

We are seeking a dedicated , professional, and detail-oriented Insurance Claim s Specialist to be part of our Risas team . Our Insurance Claims Specialist s are empowered to deliver exceptional service and support to our many dental offices . Our Insur a nce Claims Specialist are responsible for interpreting plans , analyzing information, and processing medical claims for resolution and payment .

Responsibilities:

• A nalyze insurance claim s and denials by running reports and contacting insurance c arriers for claim resolution
• Identify problem accounts or insurance providers , trends and escalat e as appropriate
• Responsible for correctly reading and interpreting insurance policies and benefits
• Collect reimbursement by gathering, coding, and transmitting patient information, resolving discrepancies, and preparing reports
• Maintain patient account records as needed and document any action taken
• Generate appeals and grievance letters to explain reasons for appeals
• Research / I dentify coding or clinic al issues and correct errors in a timely manner for maximum reimbursement
• Resolve disputed claims by gathering, verifying, and providing additional information
• Perform all types of complex adjustments to patient accounts and resolves any issues
• Follow-up with insurance carriers via phone and web portals
• Willingness to cross-train in additional departments i.e., payment posting or EDI support
• Any additional duties and responsibilities as assigned

Qualifications:

• High School Diploma or GED
• Bilingual English/Spanish preferred
• Experience with medical billing, dental billing, and accounts receivable preferred
• Knowledge of u nderstanding Explanation of Benefits (EOB), ADA forms, and insurance billing processes preferred
• Proficient w ith M/S office products including Word, Excel, and Outlook
• Excellent interpersonal, communication, and telephone skills establishing positive relationships
• Commitment to providing exceptional service, support, and education to patients and teammates
• Ability to think creatively, problem solve, and work independently
• Must have a growth mindset and ability to adapt to change

Benefits:

Risas Dental and Braces offers a comprehensive benefits package including :

• Medical and vision benefits
• Free dental services
• 401(k) with employer match
• Pai d Time Off
• Tuition reimbursement opportunities
• And many other ancillary benefits

The working environment is fun, fast paced, challenging, and rewarding with opportunities for professional development and career advancement. Join us in this work. Begin a career that is full of meaning and value.