Northeast Delta Dental
  • 12-Sep-2017 to 20-Nov-2017 (EST)
  • Concord, NH, USA
  • Full Time

Employees enjoy many great benefits including health, dental, vision, and retirement plans, an onsite fitness center and wellness opportunities, development opportunities, a pleasant work environment, and so much more!


Do you have experience with Electronic Eligibility files and 834 transactions? Do you have strong analytical and problem solving skills? Then apply today!

The ideal candidate will have a broad knowledge of online eligibility tools and electronic eligibility file formats. Exceptional communication and customer service skills are essential. Must be attentive to detail and have excellent analytical and critical thinking skills.

Responsibilities:

Implements new electronic group enrollments by receiving and entering eligibility records into the custom enterprise system. Updates current records as needed.

Reviews enrollment data for accuracy by comparing and analyzing error reports and performing group audits. Collaborates with TPAs and employer groups to reconcile discrepancies and update records. 

Improves claims adjudication by performing scenario testing, researching errors, and updating enrollment data in the custom enterprise system.

Promotes accurate electronic file submissions by educating and training employer groups and TPAs about file formatting and requirements.

Provides excellent customer service to employer groups by processing electronic eligibility files accurately and in a timely fashion; answering calls, and responding to email inquiries.

Provides training, guidance, and information on electronic enrollment by maintaining and enhancing knowledge about the process and rules around setting up and receiving 834 transactions, electronic enrollment transactions, the subscriber benefit administration tool, and eligibility modules in the custom enterprise system.

Maintains accurate process and procedure reference guides by documenting, reviewing, and updating department manuals, training materials, and related documentation.

Education and/or Experience:

Associates Degree in Business, Computer Science, or related field, plus at least two years of progressively responsible eligibility or enrollment experience or an equivalent combination of training, education, and/or experience.  Must be proficient in the use of the Microsoft Office suite. Experience with online enrollment tools and electronic enrollment file formats required. Must have a working knowledge of HIPAA 834 transactions.

Professional Competencies:

Analytical Thinking: High level of reasoning, analytical, and problem solving ability.

Communication: Excellent listening skills; excellent written and oral communication skills. Expresses ideas effectively.

Interpersonal: Establishes and maintains positive relationships.

Initiative: Self-motivated; actively seeks and identifies opportunities to contribute to and achieve goals. Applies original thinking in approach to job responsibilities and to improve processes, methods, systems, or services.

Planning & Organizing: Prioritizes and meets deadlines effectively.

Quality: Detail-oriented; monitors and checks work to meet quality standards; demonstrates care and thoroughness; checks work to ensure completeness and accuracy.

Teamwork: Works cooperatively and collaboratively with individuals and groups; addresses and resolves conflict.

 

Northeast Delta Dental
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