DentaQuest · 19 hours ago
Sr. Claim Processing Representative, DentaQuest
Kansas City, MO
Full-time
Hybrid
Mid, Senior Level
$47K/yr - $64K/yr
4+ years expDentaQuest is a leading provider of dental and vision benefits, managing services for over 33 million Americans. The Sr. Claim Processing Representative is responsible for processing advanced and complex claims accurately and efficiently, while also assisting in various claim-related tasks and projects.
DentalHealth CareHospitalInsuranceMedicalWellness
Responsibilities
Consistently process advanced & complex claim queues with a 99% or greater accuracy rate
Uses business knowledge to resolve advanced claim processing scenarios including, but not limited to, COB (coordination of benefits), ORTHO (orthodontia) cases, TPL (third party liability), and manual pricing
Responsible for adjustments to complex claims, as necessary, to meet corporate goals
Process Direct Member Reimbursement claims, to include calling providers and members for missing information
Serve as back up to Claim administration team by processing adjustments, posting check refunds and completing follow ups
Serve as back up to Claim Research and Resolution team by researching and resolving claim issues
May serve as back up to Team Lead in daily reporting
Successful completion of more complex projects, as assigned
Perform other duties as requested
Qualification
Required
Associates degree and/or four years of experience in a business environment
Strong math skills
Previous claim processing experience required
Attention to detail, accuracy and organization skills are essential
Understanding of general insurance guidelines
Ability to efficiently operate computer
Strong interpersonal, written and verbal communication skills
Self-motivation demonstrated by taking initiative to learn more and assume new challenges
Cooperative, professional and effective interaction skills with co-workers, business partners and visitors
Ability to work in excess of 40 hours in one week
Ability to use Microsoft Office (Word, Excel and Outlook)
Able to follow verbal and written instructions
Ability to communicate in an active environment
Ability to communicate via telephone or computer technology, via written and verbal channels
Benefits
Generous vacation and sick time
Market-leading paid family, parental and adoption leave
Medical coverage
Company paid life and AD&D insurance
Disability programs
Partially paid sabbatical program
401(k) employer match
Stock purchase options
Employer-funded retirement account
Company
DentaQuest
DentaQuest is a healthcare firm that provides medical and surgical treatments and services in dentistry.
1001-5000 employees
Funding
Current Stage
Late StageTotal Funding
unknownKey Investors
SMILE Health
2023-08-08Non Equity Assistance
2021-10-03Acquired
Leadership Team
Brian Watts
CEO
Shane Patrick, MBA
Managing Client Director (Oklahoma CEO)
Recent News
2025-10-28
2025-10-16
Company data provided by crunchbase