Insurance

• Carrying out the claims examination process of dental claims with higher complexity and providing expert analysis of complicated or unusual claims
• Ensure accurate and timely processing of complex claims and estimates for reimbursement to members
• Assess dental x-rays and claims, review complex claims for completeness and follow processes for incomplete information on claims
• Assess and adjudicate complex claims and estimates, including studying dental information and plan provisions, researching, documenting results
• Communicate verbally and/or in writing with the client (member/sponsor) to obtain additional details to make informed decisions
• Produce internal and external correspondence and handle external and internal inquiries via written correspondence, e-mails and telephone
• Meet production and quality standards set for individuals, teams and department (timeliness, quality and service)
• Participate in departmental projects as required and work with Dental Consultant on contentious cases
• Collaborate with other departments/offices within the company to meet customer expectations

Dental Claims Specialist

Personal Lines Insurance Broker

Insurance Advisor

Senior Advisor, Life and Health Insurance

Claims Adjuster I – Auto

Claims Adjuster I, Auto