Claims Exception Administrator

Company Name:
Aspen Dental
Aspen Dental is on a mission to give America a healthy mouth. As the nation's premier dental services organization, we provide expert business, marketing and administrative support to the fastest growing, branded network of dental practices in the country. We take the load off of practitioners to free them up to do what they do best: practice dentistry. Together, we put patients at the heart of everything we do.
We are very pleased to offer a licensed and certified dental hygienist a new opportunity to join our dedicated Claims Exception Management Team based in our Practice Support Center in Syracuse, NY as a Claims Exception Administrator.
The person selected for this role will embody the following core competencies;
Building Effective Teams-- Creates strong morale and spirit in his/her team; fosters open dialogue; creates a feeling of belonging in the team.
Customer Focus-- Is dedicated to meeting the expectations and requirements of internal and external customers.
Drive for Results-- Can be counted on to exceed goals successfully; is constantly and consistently one of the top performers; very bottom-line oriented; steadfastly pushes self and others for results.
Ethics and Values-- Adheres to an appropriate and effective set of core values and beliefs during both good and bad times; acts in line with those values.
Managing Vision and Purpose-- Is optimistic; can inspire and motivate vision and sense of core purpose.
Adaptability-- Maintains effectiveness when experiencing major changes in work responsibilities or environment.
Continuous Learning-- Actively identifying new areas for learning; regularly creating and taking advantage of learning opportunities; using newly gained knowledge and skill on the job and learning through their application.
Hig h-Impact Communication-- Clearly and succinctly conveying information and ideas to individuals and groups in a variety of situations; communicating in a focused and compelling way that drives others' thoughts and actions.
Positive Disposition-- Demonstrating a positive attitude in the face of difficult or challenging situations.
Technical/Professional Knowledge-- Having achieved a satisfactory level of technical and professional skill or knowledge in position-related areas; keeping up with current developments and trends in areas of expertise.
Essential Responsibilities include;
Evaluates claims, x-rays, perio charting, and treatment notes
Process and review daily claim exception adjustment reports
Analyze claim exception adjustments to determine root cause and analysis
Provide continuous post analysis system and process improvement recommendations
Document and submit post analysis submission tickets for process corrections and improvements
Review and process patient credit requests resulting from claim exception adjustments
Review and process claim exception adjustment inquires submitted from field offices
Contact insurance carriers to research claim processing variations
Provide guidance and education to field offices in the area of insurance processing and claims exception management

To be viewed as a valid candidate for this position you should be able to demonstrate the following;
Licensed and or Registered Dental Hygienist.
Highly proficient use of Microsoft Office Suite applications.
Experience in dental claims review preferred.
Experience in an IBM iSeries (AS400) environment preferred.
Knowledge in dental charting and dental charting software is a plus.
Exceptional attention to detail and analytic problem solving skills.
Excellent verbal and written communication skills.
Exceptional time management and prioritization skills.
Date: 2014-05-08
Country: US
State: NY
City: East Syracuse
Postal Code: 13057
Job Type: Full-Time

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