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Dental Claims Approver II

unlimited holidays - fully flexible
Remote: 
Full Remote
Contract: 
Work from: 

Offer summary

Qualifications:

High school diploma or equivalent required; further education in a relevant field is a plus., Strong oral and written communication skills are essential., Proficient PC navigation skills, including familiarity with mainframe systems., Demonstrated mathematical, analytical, organizational, and problem-solving skills..

Key responsabilities:

  • Review and process dental claims that cannot be automatically processed by the mainframe system.
  • Apply state laws to the processing of initial claims and appeals.
  • Investigate and respond to written appeals, inquiries, and complaints regarding claims.
  • Follow up on claims that require additional information or are pending in the system.

Guardian Life logo
Guardian Life Financial Services XLarge http://guardianlife.com/
5001 - 10000 Employees
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Job description

Please note: This position has a starting pay rate of $16.83 per hour with a 3% annual bonus target.

Position Summary:

Are you a highly driven individual looking for a career in the Dental Insurance industry?  If yes, read more to find out who we are and the possibilities we can offer you.

This entry level Dental Claims Approver within Group Dental Claims supports Guardian, by processing the customer’s claims timely and accurately.

You are someone who:

  • Can succeed in a highly driven production, quality and team environment.
  • Seeks developmental opportunities to help you grow in your position and career with Guardian.
  • Displays honesty and seeks feedback to understand your strengths and areas of improvement.
  • Is self-disciplined and able to work independently in a remote work environment. 

We understand that no one majors in insurance while they are in college, and that knowledge of insurance should not limit your qualifications for our available positions.  In fact, Guardian is seeking individuals with educational diversity to fuel our exciting and dynamic work environment.  

You will start your career with a strong onboarding and progressive training program.  You will be exposed to how an insurance policy works, business writing, and claims processing.  The foundational skills that you will learn involve how to process claims and provide an exceptional claims experience for our customers.

The skills and knowledge that you acquire will serve as a foundation to further develop your understanding of what Guardian has to offer. 

You have the following functional skills & position qualifications:

  • Process data entered, scanned, electronically submitted dental claims.
  • Be flexible and adaptable in an ever-changing work environment.
  • Ability to handle pressure in a production and quality focused position.
  • Open and receptive to giving and receiving feedback.
  • Ability to interact effectively with all internal and external customers.
  • Demonstrate mathematical, analytical, organizational, problem solving & relationship building skills.
  • Dependable with good attendance.
  • Willing to work overtime when requested.
  • Strong oral and written communication skills.
  • Ability to work well independently, persistent drive to meet department/ organization goals.
  • Shows agility, as well as the ability to quickly learn or adopt new skill sets.
  • Proficient PC navigation skills including mainframe systems. 
  • Maintains a high sense of priorities & uses solid judgment to make routine decisions.
  • Genuine and consistent drive to champion the customer.

You will:

A Dental Claims Approver reviews and processes claims that cannot be processed automatically by our mainframe system.  An Approver’s responsibilities may include, but are not limited to:

  • Applying state laws to the processing of initial claims and appeals.
  • Referring claims to consulting dentists to determine necessity of treatment.
  • Investigating and responding to written appeals, inquiries, and complaints.
  • Following up on claims that need additional information or are pending in our system.
  • This is not a customer service/call center position.  No phone work is required.
  • Our department is open from 6:00 AM PST to 6:00 PM PST, and colleagues work 40 hours a week and need to meet and maintain productivity and quality goals.  During training, the scheduled start time will be between 6:00 AM PST and 8:00 AM PST.
  • At times throughout the year, especially during our peak seasons, we require overtime to meet our service requirements.

Reporting Relationships:

This position reports to the Team Leader, Group Dental Claims, who in turn reports to the Manager, Group Dental Claims

Salary Range:

$30,960.00 - $46,440.00

The salary range reflected above is a good faith estimate of base pay for the primary location of the position. The salary for this position ultimately will be determined based on the education, experience, knowledge, and abilities of the successful candidate. In addition to salary, this role may also be eligible for annual, sales, or other incentive compensation.

Our Promise

At Guardian, you’ll have the support and flexibility to achieve your professional and personal goals.  Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.

Inspire Well-Being

As part of Guardian’s Purpose – to inspire well-being – we are committed to offering contemporary, supportive, flexible, and inclusive benefits and resources to our colleagues. Explore our company benefits at www.guardianlife.com/careers/corporate/benefits. Benefits apply to full-time eligible employees. Interns are not eligible for most Company benefits.

Equal Employment Opportunity

Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age, race, color, creed, religion, sex, affectional or sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law.

Accommodations

Guardian is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Guardian also provides reasonable accommodations to qualified job applicants (and employees) to accommodate the individual's known limitations related to pregnancy, childbirth, or related medical conditions, unless doing so would create an undue hardship. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact applicant_accommodation@glic.com.

Current Guardian Colleagues: Please apply through the internal Jobs Hub in Workday.

Required profile

Experience

Industry :
Financial Services
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Analytical Skills
  • Communication
  • Adaptability
  • Analytical Skills
  • Organizational Skills
  • Detail Oriented
  • Problem Solving
  • Time Management
  • Teamwork
  • Reliability

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