Senior Provider Onboarding Specialist bei 1230-DDC - OHIC Technology
1230-DDC - OHIC Technology · Alpharetta, Vereinigte Staaten Von Amerika · Hybrid
- Senior
- Optionales Büro in Alpharetta
This position acts as a subject matter expert on provider contracting and credentialing tasks for all lines of business. This position is also responsible for analyzing escalations and providing root cause analysis to identify system/business process enhancements, and acts as a trainer and mentor to lower – level team members. They will evaluate key source documentation relevant to setting up and maintaining the integrity of provider contract and credentialing information within the Provider System of Record.
Responsibilities
- Assists in the coordination and distribution of work; runs analytics on inventory to track if production expectations, performance guarantees, and customer service levels are being met.
- Acts as subject matter expert; Responsible for special handling accounts, escalations from team members, and participating in end-to-end process improvement, with emphasis on system enhancement and/or training gaps. This includes assistance with the development of Test Cases for system enhancements or process improvement initiatives.
- Assesses daily escalations and performs root cause analysis; coordinates cross-functional meetings with stakeholders to assess overall impact and solutions to be implemented as part of the resolution plans.
- Assists with project improvement strategies to ensure escalations associated with provider onboarding are mitigated and monitored.
- Performs monthly provider roster modifications and review of file discrepancies using Bump & Compare/Vlookup data solutions; performs provider contract and fee reconciliations in system of record as required through GSR reprocessing fee escalations and SWOT analysis reviews.
- Triages communications with providers to handle escalated inquiries or situations and follows through with partners to ensure full circle resolution and service levels are met.
- Provides guidance to internal and external customers on various items related to provider onboarding, including contracting requirements and SLA expectations for all lines of business. When errors occur, provides feedback and recommendations to management for resolution.
- Maintains the integrity of an electronic database and assists team members and dental provider’s offices with entering provider contract details, business name changes, tax ID changes, termination of dental contracts, change of ownership, sale of practices, adding associates, license changes, dental specialty changes, updated contract information, management exceptions and research of claims processing issues.
Qualifications
Minimum Qualifications
- 3+ years of experience w/High School
Additional Experience
- Bachelor's degree preferred. Experience working with high-profile or sensitive clients.
Knowledge, Skills, Abilities
- Strong organizational/time management skills, with the ability to multi-task while maintaining excellent attention to detail
- Strong analytical, critical thinking and problem-solving skills
- Aptitude to learn and develop proficiencies with new concepts, legal requirements, processes and technology
- Effectively able to adapt to change and be comfortable handling risk and uncertainty
- Customer-focused with ability to empathize with customer
- Understands process flows and is able to identify roadblocks and devise solutions to improve processes
- Ability to maintain confidentiality when exposed to sensitive information
- Effectively able to teach less-senior employees department processes, policies and concepts
- Strong interpersonal, written, and verbal communication skills
- PC literacy; MSOffice skills (Outlook, Word, Excel, PowerPoint, MS Teams) with strong Word skills;
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 15. $40,500 - $84,800
About Company
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.
Company
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:
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- 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.
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