Claims Examiner

Join Delta Dental of Oklahoma, the leading dental benefits provider in the state of Oklahoma.

  This position will work 40 hours per week. 

    Equal Opportunity Employer - Minority/Female/Disability/Veteran

DUTIES

Responsible for the research and processing of all adjustment requests, and ensuring correct benefits and policies are applied according to contracts and DDOK processing policies. Process Focused Review claims and act as backup to Claims Examiner. Serve as DDOK’s contact representative for major group accounts regarding claim related issues.

QUALIFICATIONS

• High School Diploma or equivalent
• Three (3) or more years of chairside dental assistant experience or Certified Dental Assistant.
• Ability to data enter 4500 KSPH alpha & 5000 KSPH numeric.
• A thorough understanding of dental procedure codes and dental terminology.
• Must be able to determine correct procedure benefit and qualifications when reviewing documentation and/or dental radiographs that have been submitted with all claims and predeterminations.
• Ability to view radiographic images with accuracy.
• Working knowledge of Microsoft Word, Outlook, and Excel.

Additional Qualifications for Consideration 

• Knowledge of the aQden claims processing system.
• A thorough understanding of DDOK’s Processing policies and how they apply to all contracts in force.
• Expanded chairside dental assisting duties that includes Radiographic Safety certification.

Current Openings for Claims Examiner Jobs at Delta Dental of Oklahoma