This position is responsible for reviewing more complex dental, vision and/or other various assigned claim types for accuracy and compliance with group and Delta processing guidelines. The Claims Examiner will also process claims, achieving the minimum acceptable number of claims per day at or above the current acceptable accuracy/quality rates.

Responsibilities:

• Performs first- and second-level claim review and inputs corrections to enable system adjudication of claims.
• Adjudicates claims in accordance with company and/or regulatory guidelines.
• Collaborates with appropriate department(s) based on company and/or regulatory guidelines to enable accurate claim adjudication.
• Refer escalated claims or process issues to management as appropriate.

• 3+ years of experience w/High School

• 2+ years' experience in a similar role; Associate degree preferred. Required to successfully complete level 1 and level 2 training and examinations.

• Analytical, problem solving and reasoning skills; detail orientation.
• Good organizational/time management skills and multi-tasking abilities.
• Ability to work under pressure and meet deadlines.
• Ability to follow verbal and written instructions.
• Ability to effectively communicate problems/questions/explanations.
• Knowledge of Delta Dental systems/organization and knowledge of health care industry issues preferred.

• Competitive base and incentive pay
• 401(k) with robust matching and non-matching contributions
• Rich medical & pharmacy benefits
• 100% employer-paid dental and vision benefits
• Holistic wellbeing program with deep financial incentives
• Generous paid time off plus 12 paid holidays and your birthday off
• Culture of growth and learning: career development; tuition reimbursement; recognition program
• Family support: adoption assistance, fertility treatment, child, elder & pet care assistance
• Social responsibility and volunteer opportunities
• Employee discount program