A Professional Review Specialist reviews dental claims and ensures policy coverage aligns with payment policies. This includes review of clinical documentation and patient history; application of claims processing policies; and consulting with the dental consultant team.
Excellent customer service is expected with a variety of audiences, including dental offices, plan holders (members), and colleagues from other DDSD departments.
Data Entry/Record Keeping
Meticulously document all steps in the process and resulting decisions, including those from the dental consultants, for the proper benefit determination and adjudication of the claim.
Other duties as assigned
Delta Dental provides an excellent compensation and benefit package including medical, dental, vision, life & disability insurance, paid vacation, sick leave, continuing education and 401k. More information about benefits and company culture is available on our Careers page.
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