Denial Management Professional (Hyderabad)

- Review and analyze denied or underpaid Denti-Cal dental claims - Work on claim reconsiderations, appeals, TAR-related denials, and resubmissions - Understand and interpret Denti-Cal EOBs, denial codes, and payer guidelines - Verify claim status through payer portals, IVR systems, and clearinghouses - Prepare and submit CRA forms, appeals, corrected claims, and supporting documentation - Review clinical documentation including SOAP notes, narratives, X-rays, and TAR approvals - Identify trends and root causes for denials and provide feedback to operations teams - Coordinate with eligibility, claims submission, and provider offices for claim resolution - Ensure timely follow-up on aging AR and denied claims - Maintain productivity and quality standards as defined by management - Document account activities accurately in billing systems and trackers Required Skills: - Experience in AR follow-up or dental claims statusing - Knowledge of TAR, NOA, CRA, and Denti-Cal authorization processes - Familiarity with payer portals such as Denti-Cal, Delta Dental, Aetna, Cigna, etc. - Experience handling appeals and reconsiderations for denied dental claims .