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] m