Claims Analyst ~ Dental Insurance

Job Description

Job Description

Join Our Award-Winning Team at Northeast Delta Dental as a Dental Claims Analyst!

Named one of the 2025 Best Companies to Work For in New Hampshire by Business NH Magazine , we offer competitive pay, outstanding benefits, workplace flexibility, and exciting career growth opportunities.

Our Claims Edit Department in Concord, NH is seeking a  full-time, Claims Analyst to assure accurate adjudication, refunds, and adjustments of dental claims by reviewing, researching, and/or returning suspended dental claims in accordance with appropriate departmental processes.

The Dental Claims Analyst role offers a competitive hourly salary at $23.00 to $24.00 based on experience. Enjoy excellent benefits, including health, dental, vision, PTO, holidays, a 401(k), tuition reimbursement, and more!

Some of the Responsibilities for this Role :

• Adjudicates claims using Northeast Delta Dental and New England Dental Administrators, LLC, processing policies by reviewing, correcting, editing, and researching suspended claims; contacts dental offices, as necessary, to obtain routine missing information or to correct information. Researches, corrects and processes claims queries.
• Processes claims requiring special handling, special consideration, and manual pricing by following the applicable processes noted in the department manual outlined for specific programs/groups/benefits (for example, Ortho, Head Start, Exchanges, New England Dental Administrators, LLC).
• Resolves Dental Coordination of Benefits (COB), Dual Delta, and medical claims based on coordination of benefits guidelines; ensures the accuracy of benefits allocation between primary and secondary dental and medical carriers.
• Calculates refunds for the Customer Service staff, verifies coordination of benefits resolutions and provides information to questions about claims payments.
• Assures appropriate documentation, X-rays, and/or any applicable notes are attached before forwarding claims to consultant review by reviewing claims and returning claims missing information to the dental offices.

Skills, Abilities & Knowledge for this Role: At least two years claims processing or insurance related experience, or an equivalent combination of training, experience, and/or education. Must be proficient in Microsoft Excel and Word. Must possess thorough knowledge of CDT coding and dental terminology and be able to perform routine mathematical computations and calculations

Work Schedule for this Role: The typical work schedule for this position is Monday - Friday, 8:00 a.m. - 4:00 p.m. for this 37.5 hour per week position.  This is a hybrid position (2-3 days in the office) after on site training at our One Delta Drive location.

All Candidates must be authorized to work for any employer in the United States without sponsorship now and in the future.

Northeast Delta Dental is proud to be an equal opportunity employer.