Dental Benefit Examiner (Hybrid/Remote)
This is more than a job; it's a chance to accelerate your career as a Dental Benefit Examiner! We have an opening at our office in Remote. This position requires a strong and diverse skillset in relevant areas to drive success. Earn a reliable and steady income of a competitive salary.
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Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions. This position is remote... within the state of AZ only. This remote work opportunity requires residency, and work to be performed, within the State of Arizona.  The Dental Benefit Examiner is responsible for data entry, review, and processing of dental prior authorization, retro-review requests, and referral requests. REQUIRED QUALIFICATIONS Required Work Experience  Two years of dental administrative/clinical experience required Required Education  High school degree or equivalent GED required Required Licenses  NA Required Certifications  NA PREFERRED QUALIFICATIONS Preferred Work Experience  Minimum one year of experience in a managed care organization or related healthcare delivery system Preferred Education  NA Preferred Licenses  NA Preferred Certifications  Dental assisting certification preferred Essential Job Functions and Responsibilities  Processes prior authorization requests and retro-reviews indicating final consultant or department determination, and securely inform providers of decisions  Processes referral requests in accordance with clinical review criteria  Answers incoming provider calls to research, and bring resolution 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 when appropriate medical-necessity authorization is necessary  Communicate with providers on member-related issues Competencies REQUIRED COMPETENCIES Required Job Skills  Dental administrative/clinical experience  Ability to read and interpret dental x-rays  Computer experience in Microsoft Excel, Word, Outlook Required Professional Competencies  Knowledge of Medicaid and Medicare regulations and guidelines  Knowledge of dental coding and terminology  Knowledge of HIPPA regulations Required Leadership Experience and Competencies  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 a team environment PREFERRED COMPETENCIES Preferred Job Skills  NA Preferred Professional Competencies  NA Preferred Leadership Experience and Competencies  NA Our Commitment AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group. Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply Apply Job! For more such jobs please click here!Â
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