- Scrutinizing dental claim documents & settlements
- Process claims as per the set healthcare guidelines
- Follow HIPAA guidelines
- Accurate processing of Dental claims and meeting productivity targets
- Good understanding of Claims adjudication fundamentals
- Valuable understanding of ICT & CPT Codes
- Knowledge of policy concepts like Deductible, coinsurance, copay, out of pocket
- Able to learn, adapt, implement process guideline into practice, work as a natural team-player in the process
- Handle escalations
- Need to ensure quality and productivity targets are met
- Ensure compliance with internal policies and procedures, external regulations and information
Technical Skills/other skills
- Computer navigation skills
- Keyboarding and data entry speed (minimum 30 wpm with 90% accuracy)
- Working knowledge of MS Excel and MS Word.
- Process Specific Skills
- Knowledge of Insurance principles in relation to the US Insurance industry
- Knowledge about US Culture
- Knowledge of Dental claims terminologies and processes will be an added advantage
- Strong organizational skills
- Good communication skills
- Demonstrate ability to work independently and in a team environment
- Self-disciplined and results oriented
- Ability to multi task
- Strong understanding and comprehension of the English language
- Good PC skills
- Attention to detail
- Team player
- Positive attitude