Claims Processing Specialist

Vista Robles Dental Group is seeking a detail-oriented and dedicated Claims Processing Specialist to join our team in the Health, Wellness, and Fitness industry. This role plays a vital part in ensuring accurate and timely processing of dental insurance claims, helping our patients receive the benefits they deserve while supporting the smooth operation of our practice.

As a Claims Processing Specialist, you will be at the forefront of managing insurance documentation, verifying coverage details, and collaborating closely with insurance providers. If you have a passion for precision, excellent communication skills, and a commitment to patient care, this opportunity is for you.

• Prepare, review, and submit insurance claims in compliance with company policies and insurance regulations.
• Verify insurance benefits and eligibility through various insurance portals and direct communication.
• Follow up on unpaid or denied claims, identifying issues and working toward resolution.
• Maintain accurate records of claims status, patient information, and correspondence with insurance carriers
• Assist with billing inquiries related to insurance claims and provide support to patients as needed.
• Stay current with changes in dental insurance policies, coding, and industry best practices.
• Collaborate with internal teams to improve claims processing workflows and accuracy.

• Efficiently process and submit dental insurance claims with accuracy and attention to detail.
• Verify patient insurance coverage and eligibility to facilitate seamless billing.
• Collaborate with insurance companies to resolve claim discrepancies and denials promptly.
• Maintain organized records and documentation related to claims processing.
• Support the billing and administrative teams to ensure timely reimbursement and patient satisfaction.

• High school diploma or equivalent required; Associate’s degree or certification in medical/dental billing or related field preferred.
• Minimum of 2 years experience in dental or medical claims processing or billing.
• Strong knowledge of dental insurance plans, terminology, and claim submission procedures.
• Familiarity with dental billing software and electronic claims submission platforms.
• Excellent attention to detail and organizational skills.
• Effective communication skills, both written and verbal, with the ability to interact professionally with patients and insurance representatives.
• Ability to manage multiple tasks and prioritize in a fast-paced environment.
• Proficiency in MS Office applications, especially Excel and Outlook.

• Competitive salary and performance-based incentives.
• Comprehensive health, dental, and vision insurance plans.
• Paid time off and holidays to support work-life balance.
• Opportunities for professional development and continuing education.
• Supportive and inclusive workplace culture focused on wellness and growth.
• Employee discounts on dental services and wellness programs.