Claims Examiner II
Delta Dental - Alpharetta, GA

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The incumbent in this position is responsible for reviewing more complex dental claims for accuracy and compliance with group and Delta processing guidelines and processing the minimum acceptable number of claims per day at or above the current acceptable accuracy/quality rates.

Detailed Description
  • Reviews and adjudicates dental claims utilizing Personal Computer terminals in accordance with company and/or regulatory guidelines.
  • Routes, based on edit messages, claims to appropriate departments based on company and/or regulatory guidelines.
  • Performs miscellaneous duties as assigned.
Job Requirements
  • A high school diploma or GED.
  • 3 years experience in call center or 4 years experience in a claims processing environment.
  • Ability to follow verbal and written instructions.
  • Ability to effectively communicate problems/questions/explanations.
  • Consistently meet and/or exceed minimum production and quality required for claims adjudication.
  • PC literacy required; MSOffice skills (Outlook, Word, Excel, PowerPoint); proficiency in InDesign preferred.
  • Regularly required to operate standard office equipment (personal computer, photocopy machine, fax machine, etc.).
  • Ability to work on a computer up to 7 hours a day.
  • Regularly required to sit for long periods of time, and occasionally stand and walk.
  • Regularly required to use hands to operate computer and other office equipment.
  • Close vision required for computer usage.
  • Occasionally required to stoop, kneel, climb and lift up to 25 pounds.
  • Ability to understand fairly complex written and oral instructions.
  • Ability to clearly present written information and findings.
  • Ability to communicate concepts.
  • Ability to make executive-level presentations.
  • Ability to interact well with co-workers and outside contacts.
Additional Details

As an eligible candidate for a position at Delta Dental, you must possess the following:
  • Ability to appear for work on time
  • Ability to appear at a physical location
  • Ability to perform job duties for a specific duration of time
  • Ability to follow directions from a supervisor
  • Ability to interact well with co-workers
  • Ability to understand and follow work rules and procedures
  • Ability to accept constructive criticism
  • Ability to maintain regular/consistent attendance and adhere to scheduled shifts
  • Ability to maintain regular/consistent attendance and a full-time schedule
  • Ability to maintain current status on projects
  • Ability to stay current on training/issues in field

How To Apply

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Minimum Salary

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Amount of Travel

Work At Home

Delta Dental - 10 months ago - save job - block
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About this company
71 reviews
Delta Dental of California doesn't just help keep the mouths of movie stars clean. The not-for-profit company is a member of the Delta...