Come Smile with Us!

Are you passionate about ensuring operational excellence and delivering exceptional quality service? Join our team as an Opertations Coordinator, where you will play a pivotal role in providing high quality service and solutions. You will support Operations teams by serving as subject matter expert in our eligibility and claims processing (end to end).  You will handle escalated customer service calls and claim inquiries; coordinate and conduct training; participate in company and department projects; conduct testing; and perform quality assurance. You must be willing to learn about dental benefits and claims processes. This is an opportunity to work in a highly collaborative, self-managed team environment with internal and external stakeholders to ensure Delta Dental’s exceptional quality service values are consistently delivered. Seeking a customer-focused and proven member of highly effective teams. This is a hybrid position located in Johnston, Iowa. 

Why Delta Dental of Iowa?

For your smile. For your health. For your community.

At Delta Dental of Iowa, we’re more than just a dental and vision insurance company. Improving health and wellness is at the center of everything we do. As a not-for-profit, we aim to build stronger communities by investing in actions that promote and improve health. Delta Dental of Iowa invests 40% of our dollars directly back into the communities we serve.

Come see why we are passionate about "Bringing Smiles" to our customers. Our team enjoys competitive pay and benefits, an awesome "One Team" approach, and a company culture that fosters "Exceptional Quality Service" and "Leadership at All Levels." Together, we can make a difference – not only in Iowa but across the country.

Essential Functions and Principal Accountabilities:

• Respond to escalated customer service and claims inquiries within established turn-around times and quality expectations. 
• Answer incoming calls as needed. 
• Provide resolution to escalated stakeholder inquiries via phone, written correspondence or in person. 
• Perform Quality Assurance. Provide feedback to team members applicable to quality results. Communicate results to supervisors, managers, Compliance team, and employees, i.e ad hoc, monthly, annually.
• Train staff on claim or eligibility processes. Write and maintain processes and procedures applicable to claims, eligibility and other operations job functions.  
• Act as our frontline for EDI file management. Work with Technology, groups, brokers and vendors to ensure files are implemented and updated properly. Trouble shoot and resolve file issues.
• Possess a strong working knowledge of administrative systems, CRM and electronic tools to support team processes, lead meetings and assist with development of requirements for changes. 
• Work respectfully and collaboratively with others throughout the company. 
• Coordinate and communicate service-related issues and resolutions to ensure a high level of customer satisfaction related to stakeholder interactions with Delta Dental.
• Process suspended claims and adjustments in an accurate and timely manner for all claims queues.
• Participate in team/company projects and testing. Attend meetings for project knowledge, input and completion. Recommend improvements in workflow and processing.
• Represent Delta Dental of Iowa as well as the other Delta Dental companies in a professional manner both internally and externally.
• Establish and maintain positive working relationships with customers, co-workers and other resources.
• Maintain strict confidentiality. Adherence to all HIPAA laws required.
• Complete special projects on time and with high quality.
• Perform other duties as assigned.

1. Bachelor’s degree or three to five years applicable experience in a customer service or benefits administration environment. Previous formal or informal oversight/coaching/training experience in a call center, claim production environment or benefits administration team required. 
2. Strong focus on a metric driven and high-quality team environment strongly preferred. 
3. Knowledge of insurance reimbursement practices, i.e. processing claims, processing policies, deductibles, maximums, Coordination of benefits and dental terminology required.
4. Excellent written and verbal communication skills.
5. Demonstrated ability to interact with internal and external stakeholders in an effective and positive manner.
6. Demonstrated competency in computer skills, including Microsoft Excel, Word, and database/data warehouse environment as well as other software as required.
7. Ability to analyze information and make independent decisions. 
8. Ability to work independently and as part of a team to complete assigned tasks and achieve goals.
9. Demonstrated ability to prioritize, organize and function effectively with multiple tasks/assignments.
10. Ability to meet with stakeholders and respond to their questions and concerns in a professional manner.
11. Intermediate math skills.
12. Dependability in attendance and punctuality required.

Delta Dental of Iowa is an Affirmative Action and Equal Opportunity Employer committed to providing equal employment opportunity for all persons without unlawful regard of race, color, religion, sex, sexual orientation, gender identity, age, national origin, individuals with disabilities, protected veteran status, or any other legally protected basis.

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