Delta Dental of Michigan, Ohio, and Indiana is looking for a Claims and System Support Specialist to oversee our claims system configurations and adjudication processes. You'll be a key operational support resource, resolving escalated issues and assisting in system updates and documentation for our Enterprise.
What You'll Do
- Participate in defining business requirements, reviewing Roosevelt system design, user acceptance testing, and implementation procedures.
- Evaluate and communicate the impact of system changes on various departments.
- Collaborate with Information Systems and Services teams to test and implement system updates and enhancements.
- Audit and maintain rules relating to claims processing.
- Analyze and implement rule enhancements to improve the efficiency and accuracy of claims processing.
- Process mass adjustment requests, provide summary results to customers, and adjust claims resulting in manual adjustments.
- Document the mass adjustment process and educate other departments on its functionality.
- Provide support to business users with questions or concerns related to claim adjustments and adjudication.
- Maintain Roosevelt system configurations.
- Collaborate and communicate closely across departments to organize, update, and implement procedure manuals and claim processing reference materials.
What We're Looking For
- Bachelor’s degree in business administration or a related field.
- Three years of experience administering dental benefits or planning and executing projects.
- We will accept any suitable combination of education, training, or experience.
Technical Stack
- Roosevelt system
Work Mode
This is a hybrid position based in our Okemos, MI office.
Delta Dental of Michigan, Ohio, and Indiana will provide equal employment and advancement opportunity without regard to race, color, religion, gender, gender identity, gender expression, age, national origin, familial status, citizenship, genetic information, disability, sex, sexual orientation, marital status, pregnancy, height, weight, military status, or any other status protected under federal, state, or local law or ordinance.
