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Join the Pack! A community with nearly 8,000 faculty and staff, and 30,000 students. NC State is one of the largest employers in North Carolina, offering a large range of career opportunities. Visit us at https://jobs.hr.ncsu.edu/.

Department: 480502 - UHR UTS/UNC Partnership

Essential Job Duties:

This Insurance Specialist position offers both dental and medical insurance services . The Insurance Specialist works in all areas of billing and reimbursement, including private dental insurance companies and managed care organizations. This role requires specialized knowledge of insurance industry standards related to billing and reimbursement, along with a strong understanding of accounts receivable.

This position collaborates closely with private insurance carriers, particularly those contracted with the clinics. It also requires a comprehensive understanding of dental and medical terminology, dental procedural and diagnostic coding, medical-dental cross-coding, electronic claims processing, and the policies and contracts of multiple insurance vendors.

Other Work/Responsibilities:

Other duties as needed

Required Qualifications:

+ The responsibilities of this role include filing dental insurance claims and pre-treatment estimates for privately insured patients; obtaining and providing the clinical documentation necessary for claims processing, such as x-rays, chart notes, and letters of necessity;

+ Investigating denied claims, following up on those investigations, and submitting appeals for those denied claims;

+ Verifying essential documentation including insurance cards, insurance explanations of payment, provider narratives, and insurance consent; and regularly auditing patient records for accuracy and completeness of billing, coding, and clinical documentation

+ This position will require extensive communication with various insurance companies, along with effective use of insurance portals.

+ Effective communication and deductive reasoning are essential skills.

+ Compliance with HIPAA regulations is mandatory.

Preferred Qualifications:

+ 1–3 years of experience filing dental insurance claims and pre-treatment estimates for private insurance plans.

Required license or certification:

N/A

Position Number: 48SM89

AA/EEO Statement:

NC State University is an equal opportunity employer. All qualified applicants will receive equal opportunities for employment without regard to age, color, disability, gender identity, genetic information, national origin, race, religion, sex (including pregnancy), sexual orientation, and veteran status. The University encourages all qualified applicants, including protected veterans and individuals with disabilities, to apply. Individuals with disabilities requiring disability-related accommodations in the application and interview process are welcome to contact 919-513-0574 to speak with a representative of the Office of Equal Opportunity.

If you have general questions about the application process, you may contact Human Resources at (919) 515-2135 or [email protected].

Final candidates are subject to criminal & sex offender background checks. Some vacancies also require credit or motor vehicle checks. Degree(s) must be obtained prior to start date in order to meet qualifications and receive credit.

NC State University participates in E-Verify. Federal law requires all employers to verify the identity and employment eligibility of all persons hired to work in the United States.