Dental Claims Resolution Specialist

Dental Claims Resolution Specialist - Full-Time

Monsey, NY (On-site)
$21-$24/hour | Full-Time

Keep Claims Moving. Keep Our Practices Running Strong.

Our organization operates a growing network of dental practices across New York State and New Jersey. We're looking for a detail-oriented, analytical Dental Claims Resolution Specialist to join our centralized Revenue Cycle Management (RCM) team. In this role, you'll take ownership of outstanding dental insurance claims across multiple practice locations - researching denials and rejections, resolving underpayments and suspended credits, reconciling insurance payments, and working directly with insurance carriers and practice teams to keep accounts receivable clean and current.

This is an ideal opportunity for someone who enjoys solving problems, working with numbers and claims data, and seeing an issue through from investigation to final resolution.

Pay & Perks

$21-$24/hour (commensurate with experience)

Full-Time opportunity

Annual Reviews & Career Growth Opportunities

Supportive, collaborative team environment

Opportunity to work across a growing multi-practice dental organization

Schedule

Full-Time | Monday-Friday

8-hour shifts

On-site in Monsey, NY

What You'll Do

• Resolve claims. Review, research, and resolve outstanding, denied, rejected, and underpaid dental insurance claims across multiple practice locations.

• Clear suspended credits. Investigate suspended credits and payments that have not been properly attached to a patient account or claim, tracing insurance remittance information back to the correct patient encounter.

• Reconcile payments. Compare insurance EOBs and ERAs against payments posted in the practice management system to identify and correct discrepancies.

• Identify unattached procedures. Review completed procedures that were not attached to or billed on an insurance claim and take the necessary steps to ensure billable services are properly submitted.

• Manage appeals and corrections. Prepare and submit corrected claims, reconsiderations, and formal appeals with appropriate supporting documentation while tracking claims through final resolution and within applicable timely filing deadlines.

• Work with insurance carriers. Contact Delta Dental, Medicaid, Medicaid Managed Care plans, commercial dental payers, and other insurance carriers through phone, payer portals, and clearinghouse tools such as DentalXchange.

• Monitor accounts receivable. Review AR aging reports and prioritize follow-up on high-dollar and aged claims to minimize outstanding balances and potential write-offs.

• Support eligibility verification. Verify patient eligibility, insurance coverage, and benefit information as needed to support claim resolution and prevent recurring issues.

• Identify trends. Monitor denial and rejection patterns across payers and locations and communicate opportunities to improve front-end processes, coding, or documentation.

• Collaborate with practices. Partner with front-office and clinical teams to resolve coding, documentation, data-entry, or scheduling issues that may be delaying claim payment.

• Maintain documentation. Keep thorough and accurate notes on claim status, research, communication, and resolution steps within the practice management system.

• Support reporting. Assist with month-end and period-end reporting related to suspended credits, unresolved claims, and aged receivables, including spreadsheet-based payment reconciliations.

• Maintain compliance. Follow HIPAA requirements and applicable New York State insurance regulations when handling patient, claims, and payment information.

• Support audits. Assist with internal and external audits involving insurance claims and payment posting as needed.

What We're Looking For

Required:

• High school diploma or equivalent.

• Minimum 2 years of experience in dental or medical insurance claims, billing, or accounts receivable follow-up.

• Working knowledge of dental insurance claim processes, EOB/ERA interpretation, and CDT procedure codes.

• Experience with dental or medical practice management software and insurance clearinghouses.

• Strong Microsoft Excel skills, including the ability to work with pivot tables and reconcile data from multiple sources.

• Excellent attention to detail and strong analytical and problem-solving skills.

• Ability to trace discrepancies back to their root cause across multiple documents and systems.

• Strong written and verbal communication skills.

• Ability to manage a high volume of claims across multiple practice locations while meeting deadlines.

Preferred:

• Associate's degree in healthcare administration, business, or a related field.

• Prior experience working in a multi-location dental service organization (DSO) or group dental practice.

• Experience with New York State and New Jersey Medicaid Managed Care dental plans.

Why You'll Love Working Here

This is more than a claims follow-up position. You'll play an important role in keeping a growing network of dental practices financially healthy and ensuring that completed patient care is properly and accurately reimbursed.

You'll enjoy:

• A supportive, collaborative work environment

• The opportunity to work with a growing multi-practice dental organization

• Exposure to a wide range of dental insurance carriers and claims situations

• Opportunities to develop your knowledge of dental revenue cycle management

• Career growth opportunities

• A role where your attention to detail and problem-solving skills have a direct impact on the organization

Ready to Make a Difference?

Bring your dental insurance knowledge, analytical skills, and attention to detail to a growing organization where your work matters. If you enjoy solving complex claims issues, working across teams, and taking ownership from the first investigation through final resolution, we'd love to hear from you. Apply today and grow with our team!