Utah Retirement Systems

  • Dental Claims Adjuster

    Location UT-Salt Lake City
    Posted Date 3 weeks ago(6/6/2018 10:32 AM)
    Job ID
    2018-2567
    Category
    Claims Processing
    Min
    USD $14.10/Hr.
    Max
    USD $17.63/Hr.
  • About The Company

    A division of Utah Retirement Systems, PEHP is a non-profit trust with the vital job of providing health benefits to Utah’s public employees and their families.

    Job Description

    Summary:

    Performs a variety of complex clerical duties to expedite the day to day processing and adjudication of dental claims.

     

    Duties and Responsibilities:

    1. Receives and enters dental claims for payment under dental plans.
    2. Reviews claims for accuracy and completeness, verifies coverage and eligibility of patient.
    3. Adjudicates routine and complex claims according to established policy guidelines.
    4. Reviews pre-authorizations and x-rays for benefit determination following established policy guidelines.
    5. Prepares and follows up with dental consultants on claims being reviewed and provides additional information as required.
    6. Maintains strict confidentiality.
    7. Performs other related duties as required.

    Required Experience

    Education and Experience

    High School Diploma and one (1) year of progressively responsible experience performing variety of complex clerical duties to expedite the day to day processing and adjudication of dental claims; or an equivalent combination of education and experience.

     

    Specific experience in claims processing, and various administrative functions is preferred.

     

    Knowledge, Skills, and Abilities

    Requires a working knowledge of dental claims adjudication policies, procedures and processes; intricacies related to dental care processes and terminology; dental X ray technology; of various office management systems related to alpha and numeric record keeping; interpersonal communication skills;  telephone etiquette;  personal computer operations (PC/MS DOS) and various  program applications; basic bookkeeping, negotiation techniques; training methods; 10 key operation;  basic mathematics;  some knowledge of basic public relations.

     

    Must have the ability to  recognize a variety of routine management issues and problems and make routine corrections; communicate effectively verbally and in writing; ability to follow verbal instructions; establish and maintain effective working relationships with professionals, department heads, co workers and the public; and  work independently and deal effectively with stress caused by work load and time deadlines.

     

    Work Environment

    Incumbent performs in a typical office setting with appropriate climate controls.  Tasks require a variety of physical activities which do not generally involve muscular strain, but do require activities related to walking, standing, stooping, sitting, reaching, talking, hearing and seeing.  Common eye, hand, finger dexterity required to perform essential functions. 

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