Dental Benefit Examiner - Remote Opportunity with Blue Cross Blue Shield of Arizona - Data Entry, Review, and Processing of Dental Prior Authorizations

Join Blue Cross Blue Shield of Arizona as a Dental Benefit Examiner and Accelerate Your Career!

Blue Cross Blue Shield of Arizona is on a mission to inspire health and make it easy. As a leading health insurance provider, we offer a range of products and services to individuals, families, and businesses. We're proud to be recognized as a Healthiest Employer, and we're committed to fostering a culture that prioritizes health, well-being, and inclusivity. We're now seeking a skilled and detail-oriented Dental Benefit Examiner to join our team in a remote capacity within the state of Arizona.

About the Role

As a Dental Benefit Examiner, you will play a critical role in ensuring that our members receive the dental benefits they need. You will be responsible for data entry, review, and processing of dental prior authorizations, retro-review requests, and referral requests. This is a fantastic opportunity to leverage your dental administrative and clinical experience to drive success in a dynamic and fast-paced environment.

Key Responsibilities

• Process prior authorization requests and retro-reviews, indicating final consultant or department determination, and securely inform providers of decisions
• Process referral requests in accordance with clinical review criteria
• Respond to incoming provider calls, researching and resolving provider questions, problems, or concerns
• Verify eligibility for coverage of dental benefits to avoid duplication of services and billing
• Collaborate with the dental director to recommend consultant review when necessary
• Communicate with providers on member-related issues

Qualifications and Requirements

To be successful in this role, you will need to meet our required qualifications:

Required Qualifications

• Two years of dental administrative/clinical experience
• High school degree or equivalent GED

Preferred Qualifications

• Minimum one year of experience in a managed care organization or related healthcare delivery system
• Dental assisting certification preferred

Essential Skills and Competencies

We're looking for candidates with the following essential skills and competencies:

Required Job Skills

• Dental administrative/clinical experience
• Ability to read and interpret dental x-rays
• Computer experience in Microsoft Excel, Word, Outlook

Required Professional Competencies

• Knowledge of Medicaid and Medicare regulations and guidelines
• Knowledge of dental coding and terminology
• Knowledge of HIPPA regulations

Required Leadership Experience and Competencies

• Effective time management skills
• Effective interpersonal and communication skills
• Ability to prioritize work tasks to adhere to deadlines and identified time frames
• Ability to work cooperatively, positively, and collaboratively in a team environment

What We Offer

At Blue Cross Blue Shield of Arizona, we're committed to providing a supportive and inclusive work environment that fosters growth and development. As a Dental Benefit Examiner, you can expect:

• A competitive salary and benefits package
• Opportunities for career growth and professional development
• A dynamic and collaborative work environment
• Recognition and rewards for outstanding performance

Our Commitment to Diversity and Inclusion

At Blue Cross Blue Shield of Arizona, we're dedicated to creating a workplace that is inclusive and respectful of all employees, regardless of their background, culture, or identity. We do not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status, or any other protected group.

Ready to Join Our Team?

If you're a motivated and detail-oriented professional with a passion for delivering exceptional customer service, we want to hear from you! As a Dental Benefit Examiner with Blue Cross Blue Shield of Arizona, you'll have the opportunity to make a meaningful contribution to our mission while developing your skills and expertise. Apply now to take the first step in your career journey!

We're excited to welcome a talented and dedicated Dental Benefit Examiner to our team. With a strong foundation in dental administrative and clinical experience, you'll be well-equipped to succeed in this role and drive success for our organization. Don't miss this opportunity to join our team and accelerate your career - apply today!