Dental Claims Approver II

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 Group 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.

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.  

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.

Travel:

0% of travel required for this role.

Our promise:

• 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

We offer:              

• Meaningful and challenging work opportunities to accelerate innovation in a secure and compliant way.
• Competitive compensation package.
• Excellent medical, dental, supplemental health, life and vision coverage for you and your dependents with no wait period.
• Life and disability insurance.
• A great 401(k) with company match.
• Tuition assistance paid parental leave and backup family care.
• Dynamic, modern work environments that promote collaboration and creativity to develop and empower talent.
• Flexible time off, dress code, and work location policies to balance your work and life in the ways that suit you best.
• Employee Resource Groups that advocate for inclusion and diversity in all that we do.
• Social responsibility in all aspects of our work. We volunteer within our local communities, create educational alliances with colleges, drive a variety of initiatives in sustainability