Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements:Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per weekHybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per weekHybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per monthOnsite: daily onsite requirement based on the essential functions of the jobRemote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team buildingPlease note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week.This position is remote within the state of AZ only. This remote work opportunity requires residency, and work to be performed, within the State of Arizona.PRUPOSE OF THE JOB The Dental Benefit Examiner is responsible for data entry, review, and processing of dental prior authorization, retro-review requests, and referral requests.Required QualificationsRequired Work ExperienceTwo years of dental administrative/clinical experience requiredRequired EducationHigh school degree or equivalent GED requiredRequired LicensesNARequired CertificationsNAPreferred QualificationsPreferred Work ExperienceMinimum one year of experience in a managed care organization or related healthcare delivery systemPreferred EducationNAPreferred LicensesNAPreferred CertificationsDental assisting certification preferredEssential Job Functions And ResponsibilitiesProcesses prior authorization requests and retro-reviews indicating final consultant or department determination, and securely inform providers of decisionsProcesses referral requests in accordance with clinical review criteriaAnswers incoming provider calls to research, and bring resolution to provider questions, problems, or concernsVerifies eligibility for coverage of dental benefits to avoid duplication of services and duplication of billingWorks in conjunction with the dental director by recommending consultant review when appropriate medical-necessity authorization is necessaryCommunicate with providers on member-related issuesThe position has an onsite expectation of 0 days per week and requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.Required CompetenciesRequired Job SkillsDental administrative/clinical experienceAbility to read and interpret dental x-raysComputer experience in Microsoft Excel, Word, OutlookRequired Professional CompetenciesKnowledge of Medicaid and Medicare regulations and guidelinesKnowledge of dental coding and terminologyKnowledge of HIPPA regulationsRequired Leadership Experience And CompetenciesEffective time management skillsEffective interpersonal and communication skillsAbility to prioritize work tasks to adhere to deadlines and identified time framesAbility to work cooperatively, positively, and collaboratively in a team environmentPreferred CompetenciesPreferred Job SkillsNAPreferred Professional CompetenciesNAPreferred Leadership Experience And CompetenciesNAOur CommitmentAZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.