Insurance Exceptions Processor

Mortenson Dental • Louisville, KY

3d

About The Position

Analyzes ERA for claims that did not auto-post for cause. Post insurance payments for claims with exceptions and accurate contract obligations to specific procedure codes on the patient ledgers. Meets daily quality and timing standards. Contact insurance carriers when necessary to assist with claim payment. This may include, but not limited to, calling with seat dates, calling with COB information, or calling to determine specific denial reasons. Retrieves EOBs from carrier websites when the ERA is not sufficient to post accurately. Direct the practice on actions that should be taken to reprocess the claim to result in payment. Update SARA with all pertinent information, including denial reasons. Audits the SARA report to ensure all payments are applied before the month-end process is complete. Supports other insurance specialists, supervisors, and managers in times of heavy claim influx.

Requirements

• High school diploma or equivalent
• Customer service
• Computer, Google suite, copier, fax, telephone

Nice To Haves

• One year dental insurance experience
• Dental practice management software

Responsibilities

• Analyzes ERA for claims that did not auto-post for cause.
• Post insurance payments for claims with exceptions and accurate contract obligations to specific procedure codes on the patient ledgers.
• Meets daily quality and timing standards.
• Contact insurance carriers when necessary to assist with claim payment.
• Retrieves EOBs from carrier websites when the ERA is not sufficient to post accurately.
• Direct the practice on actions that should be taken to reprocess the claim to result in payment.
• Update SARA with all pertinent information, including denial reasons.
• Audits the SARA report to ensure all payments are applied before the month-end process is complete.
• Supports other insurance specialists, supervisors, and managers in times of heavy claim influx.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED