Requirement:
- Must be a resident of California.
Your role in our mission:
- Evaluate dental claims, adjustments, and prior authorization requests against Medi-Cal Dental criteria.
- Generate requests to dental providers for missing claims information.
- Confirms claims documentation is complete, complies with policy, and refers documents to dental professionals when required.
- Monitors members actively receiving appropriate care/scheduled care and ensures they complete their goals.
- Maintain and record decisions, actions, and outcomes for members receiving care coordination.
- Set up tasks, reminders, and follow-ups on missed appointments
What we're looking for:
- Graduate from an accredited dental assistant school or two (2) years of prior experience working in a dental office (dental assistant, registered dental assistant, registered dental hygienist, etc.)
- Two (2) years prior experience in a dental billing and claims processing environment
- Expertise to support treatment authorization requests (TAR) and claims adjudication, including familiarity with dental radiography principles, such as orientation and tooth/structure identification.
$NURSING$INDEED
Job Type: Contract
Pay: $29.00 - $30.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Vision insurance
Schedule:
Application Question(s):
- Do you have any experience in dental billing and claims processing?
- Do you have an Active CA license?
Experience:
- Dental assisting: 2 years (Preferred)
Location:
Work Location: Remote