New

Claim Examiner II

Delta Dental of California
$36,900 - $74,600
paid time off, paid holidays, tuition reimbursement, 401(k), employee discount
United States, Georgia, Alpharetta
Jan 28, 2026
JOB DESCRIPTION This position is responsible for reviewing more complex dental, vision and/or other various assigned claim types for accuracy and compliance with group and Delta processing guidelines. The Claims Examiner will also process claims, achieving the minimum acceptable number of claims per day at or above the current acceptable accuracy/quality rates. RESPONSIBILITIES Performs first- and second-level claim review and inputs corrections to enable system adjudication of claims. Adjudicates claims in accordance with company and/or regulatory guidelines. Collaborates with appropriate department(s) based on company and/or regulatory guidelines to enable accurate claim adjudication. Refer escalated claims or process issues to management as appropriate. QUALIFICATIONS Minimum Qualifications 3+ years of experience w/High School Additional Experience 2+ years' experience in a similar role; Associate degree preferred. Required to successfully complete level 1 and level 2 training and examinations. Knowledge, Skills, Abilities Analytical, problem solving and reasoning skills; detail orientation. Good organizational/time management skills and multi-tasking abilities. Ability to work under pressure and meet deadlines. Ability to follow verbal and written instructions. Ability to effectively communicate problems/questions/explanations. Knowledge of Delta Dental systems/organization and knowledge of health care industry issues preferred. Base Pay Information The national base pay range at the end is a good-faith estimate of what Delta Dental may pay for new hires. Actual pay may vary based on Delta Dental's assessment of the candidate's knowledge, skills, abilities (KSAs), related experience, education, certifications and ability to meet required minimum job qualifications. Other factors impacting pay include prevailing wages in the work location and internal equity. Pay Grade 14. $36,900 - $74,600 ADDITIONAL INFORMATION Behind the smile! We are dedicated to safeguarding the health and financial stability of our employees and their loved ones. This commitment extends beyond the workplace to foster personal growth and holistic wellbeing. Our life-changing rewards package includes: Competitive base and incentive pay 401(k) with robust matching and non-matching contributions Rich medical & pharmacy benefits 100% employer-paid dental and vision benefits Holistic wellbeing program with deep financial incentives Generous paid time off plus 12 paid holidays and your birthday off Culture of growth and learning: career development; tuition reimbursement; recognition program Family support: adoption assistance, fertility treatment, child, elder & pet care assistance Social responsibility and volunteer opportunities Employee discount program Fair Chance Ordinances and Criminal Background Considerations This position requires that the applicant undergo a background check. Qualified applicants with arrest or conviction records will be considered for employment in accordance with any applicable federal, state or local laws, including, but not limited to, the California Fair Chance Act, the Los Angeles County Fair Chance Ordinance, the City of Los Angeles Fair Chance Initiative for Hiring Ordinance, the San Francisco Fair Chance Ordinance, and/or New York Corrections Law Article 23-A. #LI-Hybrid ABOUT THE TEAM Delta Dental Ins. is an equal opportunity employer and is committed to providing a professional work environment free from discrimination and harassment. Individuals seeking employment at Delta Dental are considered without regard to race, ethnicity, color, age, sex, religion, national origin, ancestry, pregnancy, sexual orientation, gender identity, gender expression, genetic information, actual or perceived physical or mental disability, registered domestic partner status, caregiver status, marital status, veteran or military status, citizenship status, or any other legally protected category. Delta Dental is committed to providing equal employment opportunities to all employees and applicants for employment. Accordingly, we have adopted and maintain an Equal Employment Opportunity Policy, Harassment-Free Work Environment Policy, and Respectful Workplace policies and will not tolerate violations of these policies. Unfortunately, our Delta Dental Enterprise is unable to hire individuals residing in Alaska, Hawaii, Maine, Nebraska, New Hampshire, North Dakota, Oklahoma, Vermont, West Virginia, Wyoming, Washington DC, Puerto Rico or other US Territories or outside of the United States at this time.