Dental Claims Approver II

Note: This position has a projected starting pay rate of $16.83 per hour. Position Summary: We understand that no one majors in insurance while they are in college, and that knowledge of insurance should not limit your qualifications for our available positions. In fact, Guardian is seeking individuals with educational diversity to fuel our exciting and dynamic work environment. This position is focused on providing high-quality service and collaborative claim management to our members. Are you a driven, service-oriented individual looking for a great career? If yes, read more to find out about who we are and the possibilities we can offer you. This is an entry level Retail Dental Claims Approver who will utilize their strong attention to detail to process dental claims efficiently. You are someone who: Has strong time management skills. Can succeed in a fast paced, production focused environment. Can deliver high quality results while working independently. Demonstrates self-awareness and embraces feedback. Eager to continuously learn and retain new knowledge and skills. Ability to follow standard operating procedures and navigate multiple computer applications. You will start your career with a strong onboarding and progressive training program. You will be exposed to how an insurance policy works, business writing, and claims processing. The foundational skills that you will learn involve how to process dental claims. The skills and knowledge that you acquire will ensure a high level of claims processing accuracy and serve as a foundation to further develop your understanding of what Guardian has to offer. You have the following functional skills & position qualifications: Process data entered, scanned, electronically submitted, & dental claims that can't be pended. Be able to switch mail types when requested. Ability to handle pressure in a production environment. Demonstrate analytical, organizational, problem solving & relationship building skills. Good attendance. Willing to work overtime when requested. Strong oral and written communication skills. Ability to work well independently, persistent drive to meet department/ organization goals. Shows agility, as well as the ability to quickly learn or adopt new skill sets. Proficient PC skills including mainframe systems. Demonstrate honest and ethical behavior. Maintains a high sense of priorities & uses solid judgment to make routine decisions. Genuine and consistent passion for service. You will: A Dental Claims Approver reviews and processes claims that cannot be processed automatically by our mainframe system. An Approver's responsibilities may include, but are not limited to: Applying state laws to the processing of initial claims and appeals. Referring claims to consulting dentists to determine necessity of treatment. Investigating and responding to written appeals, inquiries, and complaints. Following up on claims that need additional information or are pending in our system. This is not a customer service/call center position. No phone work is required. Our department is open from 6:00 AM PST to 6:00 PM PST, and colleagues work 40 hours a week and need to hit productivity and quality goals. During training, the scheduled start time will be between 6:00 AM and 8:00 AM. At times throughout the year especially during our peak seasons we require overtime to meet our service requirements. 0% of travel required for this role. Salary Range $30,350.00 - $45,530.00 The salary range reflected above is a good faith estimate of base pay for the primary location of the position. The salary for this position ultimately will be determined based on the education, experience, knowledge, and abilities of the successful candidate. In addition to salary, this role may also be eligible for annual, sales, or other incentive compensation. Our Promise At Guardian, you'll have the support and flexibility to achieve your professional and personal goals. Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards. Inspire Well-Being As part of Guardian's Purpose - to inspire well-being - we are committed to offering contemporary, supportive, flexible, and inclusive benefits and resources to our colleagues. Health Care Choice of [high deductible/copay] medical plans* with prescription drugs, including coverage for fertility and transgender inclusive benefits Dental plan Vision plan Health care accounts - flexible spending, health reimbursement, and health savings accounts Critical illness insurance Life and Disability Insurance Company-paid Life and Disability insurance plus voluntary supplemental coverage Accident insurance Retirement and Financial 401(k) retirement plan with a company match, plus an annual age/service-based Company contribution and an annual profit-sharing contribution, if applicable Complimentary 1:1 financial guidance with a licensed Fidelity representative Time Off and Remote Work Flexible work arrangements (part in-person/part remote) Unlimited paid time off for most roles plus time off for volunteering, jury duty, voting, and bereavement Personal holidays for colleagues to use in recognition of religious, cultural, or civic days Paid parental leave and paid family and medical leave policies Emotional Well-being and Work-Life Emotional well-being, mental health, and work/life resources powered by Spring Health Wellness programs, including fitness program and equipment reimbursement Child, adult, and elder back-up care support through Bright Horizons Adoption assistance College planning Tuition reimbursement Student loan assistance Commuter benefits in select metropolitan areas Equity & Inclusion Opportunities to build inclusive and meaningful connections through involvement in colleague-led affinity groups: Employee Resource Groups: Colleague Connection Committees Community Involvement Committees A culture that encourages colleagues to bring their authentic selves to work Voluntary self-ID Pronunciation and phonetic spelling of names Benefits apply to full-time eligible employees. Interns are not eligible for most Company benefits. Equal Employment Opportunity Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age, race, color, creed, religion, sex, affectional or sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law. Accommodations Guardian is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Guardian also provides reasonable accommodations to qualified job applicants (and employees) to accommodate the individual's known limitations related to pregnancy, childbirth, or related medical conditions, unless doing so would create an undue hardship. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact . Current Guardian Colleagues: Please apply through the internal Jobs Hub in Workday. Every day, Guardian helps our 29 million customers realize their dreams through a range of insurance and financial products and services. Our Purpose, to inspire well-being, guides our dedication to the colleagues, consumers, and communities we serve. We know that people count, and we go above and beyond to prepare them for the life they want to live, focusing on their overall well-being "” mind, body, and wallet. As one of the largest mutual insurance companies, we put our customers first. Behind every bright future is a GuardianTM. Learn more about .

Created: 2024-10-31