Claims Processing Specialist

Vista Robles Dental Group is seeking a detail-oriented and dedicated Claims Processing Specialist to join our team in the Health, Wellness, and Fitness industry. This role plays a vital part in ensuring accurate and timely processing of dental insurance claims, helping our patients receive the benefits they deserve while supporting the smooth operation of our practice. As a Claims Processing Specialist, you will be at the forefront of managing insurance documentation, verifying coverage details, and collaborating closely with insurance providers. If you have a passion for precision, excellent communication skills, and a commitment to patient care, this opportunity is for you. Key Responsibilities: Prepare, review, and submit insurance claims in compliance with company policies and insurance regulations. Verify insurance benefits and eligibility through various insurance portals and direct communication. Follow up on unpaid or denied claims, identifying issues and working toward resolution. Maintain accurate records of claims status, patient information, and correspondence with insurance carriers. Assist with billing inquiries related to insurance claims and provide support to patients as needed. Stay current with changes in dental insurance policies, coding, and industry best practices. Collaborate with internal teams to improve claims processing workflows and accuracy. Requirements: Efficiently process and submit dental insurance claims with accuracy and attention to detail. Verify patient insurance coverage and eligibility to facilitate seamless billing. Collaborate with insurance companies to resolve claim discrepancies and denials promptly. Maintain organized records and documentation related to claims processing. Support the billing and administrative teams to ensure timely reimbursement and patient satisfaction. Effective communication skills, both written and verbal, with the ability to interact professionally with patients and insurance representatives. Ability to manage multiple tasks and prioritize in a fast-paced environment. Proficiency in MS Office applications, especially Excel and Outlook. Qualifications: High school diploma or equivalent required; Associate’s degree or certification in medical/dental billing or related field preferred. Minimum of 2 years experience in dental or medical claims processing or billing. Strong knowledge of dental insurance plans, terminology, and claim submission procedures. Familiarity with dental billing software and electronic claims submission platforms. Excellent attention to detail and organizational skills. Effective communication skills, both written and verbal, with the ability to interact professionally with patients and insurance representatives. Ability to manage multiple tasks and prioritize in a fast-paced environment. Proficiency in MS Office applications, especially Excel and Outlook.
This is a remote position.

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