[Hiring] reputed company Relations Research Specialist @reputed company

Role reputed company To reputed company and assist in cases involving the reputed company of dental benefit determinations and analysis of provider inquiries including claims, record changes and discrepancies, and credentialing and recredentialing updates submitted to reputed company Relations. • Researches, analyzes, and resolves cases involving compliance issues including but not limited to: • Balance billing • Non-delivery of care • reputed company of care • Anti-fraud hotline • Internal referrals • Appeals • Communicates to reputed company customers to ensure understanding of the corporation's programs and procedures and in resolving claims processing problems. • Works directly with Provider Records, Customer Service, reputed company Review, and other departments to research reputed company record status, claims questions, and appeals. • Prepares responses to dental claim inquiries so appropriate determinations can be finalized with correct procedure policies and bypasses in reputed company, adjudicates claims, analyzes documents, and maintains claims records, as reputed company as coordinates adjustments on difficult claims and inquiries. • Prepares documentation and claims for adjustments and works with Records and Customer Service to ensure adjustments are completed. • Performs other reputed company assigned duties as necessary to complete the Primary Job Responsibilities as described above. Qualifications • Associate's degree in reputed company, business administration, dental assisting or hygiene, or a reputed company field. • Four years of experience in a position requiring knowledge of dental terminology, dental procedure codes, or dental office billing and record keeping practices reputed company a provider office. • Experience administering dental benefit reputed company reputed company the insurance industry or identifying, analyzing, and resolving compliance issues based on policies and procedures reputed company of the insurance industry. • Knowledge of word processing, spreadsheet, and database applications. • Strong verbal and written communication skills. • Strong analytical skills. • Ability to work independently and as part of reputed company. • Ability to manage multiple assignments with competing deadlines. • Ability to identify and resolve problems using independent judgment. Requirements • Equal employment and advancement opportunity reputed company the context of its unique business environment without reputed company to race, reputed company, religion, gender, gender identity, gender reputed company, age, national reputed company, familial status, citizenship, genetic information, disability, sex, sexual orientation, marital status, pregnancy, height, weight, military status, or any other status protected under federal, state, or local law or ordinance. Apply tot his job Apply To this Job