Claims Specialist

This is a Fully Remote Job About Our Client: The organization operates in the dental healthcare industry, focusing on providing patient-centered care since 1972. It addresses the challenge of delivering quality dental services through doctor-led practices equipped with advanced technology. The team emphasizes comprehensive training and community involvement to support local health initiatives. About the Opportunity: The CLAIMS SPECIALIST role is responsible for managing and resolving complex insurance claim issues to support doctors, practices, and revenue cycle teams. This position ensures timely claim processing and appeals, contributing directly to the organization's financial health and operational efficiency. Responsibilities: Proactively manage open insurance claims for prompt processing Work aging reports to track unpaid claims Collaborate with Insurance Specialists to resolve claim handling issues Review payer explanation of benefits for contract compliance Appeal and follow up on denied insurance claims Identify and resolve payer denials Provide additional information requested by payers Resolve electronic claim rejections Correct and resubmit claims in practice management systems and clearinghouses Communicate effectively with doctors and team members to promote collaboration Support a team environment based on trust, communication, and professional behavior Pursue personal professional development through training and education Adhere to organizational policies and service excellence standards Represent the organization’s mission, vision, and values Requirements: Strong communication skills and ability to build cooperative relationships High proficiency in interpreting various payers’ explanation of benefits In-depth knowledge of coordination of benefits guidelines Ability to manage multiple tasks independently with minimal supervision Detail-oriented and well-organized Self-motivated and able to work independently Able to interact effectively across multiple locations and with diverse internal customers and patients Minimum two-year associate degree required; bachelor’s degree preferred Familiarity with dental and medical insurance claims Experience communicating verbally and in writing with healthcare professionals and patients Pay Range and Compensation Package: Starting wage: $22-25 per hour Benefits & Perks: Medical, vision, and dental insurance Paid time off and holiday pay 401(k) matching Continuing education opportunities Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin. Note: TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.