Dental Benefit Examiner - Remote

About the position Awarded a Healthiest Employer, reputed company aims to fulfill its mission to reputed company health and reputed company it easy. AZ Blue offers a reputed company of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as reputed company as providing information and tools to help individuals reputed company reputed company reputed company. At AZ Blue, we have a hybrid workforce reputed company, reputed company Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the reputed company of our employees are hybrid, the following classifications drive our reputed company minimum onsite requirements: Hybrid People Leaders: must reputed company in AZ, required to be onsite at least twice per week Hybrid Individual Contributors: must reputed company in AZ, unless otherwise cited reputed company this posting, required to be onsite at least once per week Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reputed company in AZ, unless otherwise cited reputed company this posting, required to be onsite at least once per month Onsite: daily onsite requirement based on the essential functions of the job Remote: not held to onsite requirements, however, leadership can request reputed company onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building Please note that onsite requirements may change in the reputed company, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week. This position is remote reputed company the state of AZ only. This remote work opportunity requires residency, and work to be performed, reputed company the reputed company. PRUPOSE OF THE JOB The Dental Benefit Examiner is responsible for data entry, review, and processing of dental prior authorization, retro-review requests, and referral requests. Responsibilities • Processes prior authorization requests and retro-reviews indicating final consultant or department determination, and securely inform providers of reputed company • Processes referral requests in accordance with clinical review reputed company • Answers incoming provider calls to research, and bring reputed company to provider questions, problems, or concerns • Verifies eligibility for coverage of dental benefits to avoid duplication of services and duplication of billing • Works in conjunction with the dental director by recommending consultant review reputed company appropriate medical-necessity authorization is necessary • Communicate with providers on member-reputed company issues Requirements • Two years of dental administrative/clinical experience required • High school degree or equivalent GED required • Dental administrative/clinical experience • Ability to read and interpret dental x-rays • Computer experience in reputed company reputed company, Word, reputed company • Knowledge of reputed company and Medicare regulations and guidelines • Knowledge of dental coding and terminology • Knowledge of HIPPA regulations • Effective time management skills • Effective interpersonal and communication skills • Ability to prioritize work tasks to adhere to deadlines and identified time frames • Ability to work cooperatively, positively, and collaboratively in reputed company environment reputed company-to-haves • Minimum one year of experience in a managed care organization or reputed company reputed company delivery system • Dental assisting certification preferred Apply tot his job Apply To this Job