Role Description

The Dental Claims Resolution Specialist I is responsible for entering and processing dental claims in the claims system. This role requires attention to detail, strong problem-solving skills, and the ability to follow established guidelines to ensure claims are processed accurately and on time.

Compensation: Pursuant to Service Contract Act

You will review claim submissions, enter claim information into the system, identify errors or missing information, and help ensure claims move through the process efficiently.

Key Responsibilities

• Enter dental claim information into the claims processing system from paper, portal, or fax submissions
• Review claims for accuracy and correct OCR or data entry errors
• Monitor and respond to questions from the claims email queue
• Assist with resolving claims that fail electronic processing (EDI errors)
• Track claims issues using spreadsheets to ensure claims are processed within required timelines
• Research and resolve moderately complex claims issues
• Follow the full claim lifecycle to ensure claims are processed and resolved properly
• Communicate with internal teams to resolve claim issues when needed

Work Environment

• Fully remote position (U.S.-based employees only)
• Work hours will be communicated during the hiring process
• Company equipment and systems will be provided for performing job duties

Qualifications

• At least 3 years of claims processing or related experience (dental experience preferred)
• Strong attention to detail and problem-solving skills
• Proficiency with Microsoft Office (Excel, Word, Outlook)
• Ability to work independently and as part of a team
• Strong written and verbal communication skills
• Ability to manage multiple tasks and adapt to changing priorities

Preferred Qualifications

• Dental claims processing experience
• Dental office or dental assisting background
• Associate degree in Business Administration or a related field
• Dental or medical coding experience
• Healthcare or medical call center experience

Benefits

• Competitive salary
• Medical benefits
• PTO
• Holiday pay
• More

Company Description

MPF Federal is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.