Delta Dental of Michigan, Ohio, and Indiana is looking for a Claims and System Support Specialist to be a key operational partner. You will oversee claims system configurations and adjudication processes, ensuring accuracy and efficiency 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
- A Bachelor’s degree in business administration or a related field.
- At least three years of experience administering dental benefits or planning and executing projects.
- Any suitable combination of education, training, or experience.
Company Culture
Our “All In” culture is a mindset, feeling, and attitude wrapped around all that we do – from taking charge of our careers, to helping colleagues and lending a hand in the community.
Work Mode
This position is hybrid and based in our Okemos, MI office.
The company will provide equal employment and advancement opportunity within the context of its unique business environment 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.
