Delta Dental of Illinois is currently recruiting for the following position(s):
Electronic File Load Analyst
The Electronic File Load Analyst is responsible for ensuring timely and accurate processing of both inbound and outbound electronic files, sending the file to the proper recipient, and/or verifying their successful conclusion. Inbound files include but are not limited to the following: enrollment (834, spreadsheet, baseline, reconciliation, etc), 837 claims (clearinghouse and OCR vendor), 820 premium reconciliation. Outbound files include but are not limited to NPF uploads, claim repricing, claim check/EOB/EOP, commissions, bills, positive pay, NACHA and any other electronic file assigned.
DUTIES & RESPONSIBILITIES:
- Provides hands-on file manipulation, loading, and conversion services.
- Creates and modifies files for upload and performs individual file conversion in support of electronic file processing.
- Will be required to develop, evaluate and modify methodologies and procedures for manipulating files for use typically with applications utilized by the enterprise.
- Must be able to ensure the accuracy of data loading, manipulation, and conversion by performing and documenting quality and accuracy checks
- Creates and modifies files for upload, performs individual file conversion in support of electronic file processing or third party data.
- Communicates and interfaces with employers and brokers/agents to facilitate timely receipt of enterprise standard format enrollment from electronic files of all types.
- Communicates and interfaces with clearinghouses, OCR vendor, business leaders and developers to facilitate claim files of all types.
- Communicates with finance and IT to ensure timely generation and sending of claim check/EOB/EOP, commissions, bills, positive pay, and NACHA files.
EXPERIENCE & QUALIFICATIONS:
Three years file processing or related process experience required; experience with enrollment files helpful. Insurance terminology and operations experience is required. Efficiently and effectively manipulate spreadsheet-type files into standard format. Able to utilize various software tools to search within a file for needed data. Intermediate MS Excel skills required and MS Access-like applications helpful. Strong communication and customer service skills. Excellent problem-solving skills. Bachelor’s degree preferred.
Vice President and Science Officer
The VP & Science Officer reports to the CEO and is responsible for implementing new product designs working with cross-functional teams to achieve consumer desires and competitive price points. Identifies emerging technologies and trends in the dental industry and provides analysis and recommendations to the organization. Requires a strong analytical skill-set; with the ability to interpret and use data to make and support a business case. A strong understanding of trends and best practices in dentistry and improving oral health is required. Experience as a public health dentist, military dentist, and/or in dental epidemiology is a strong preference. An advanced degree DDS or DMD degree is required.
Resumes for the VP & Science Officer should be sent to Lauren at email@example.com for this position only.
Delta Dental of Illinois
111 Shuman Boulevard
Naperville, IL 60563