Claims Processing Coordinator Jobs

JOB DESCRIPTION
The Claims Processing Coordinator serves as a team lead and is responsible for coaching, supporting, and engaging a claims processing workforce in day-to-day operations. This position supports the Supervisor in ensuring all work is completed in a timely and accurate manner and that department objectives and goals are achieved. The Coordinator will also support Examiners on escalated situations and assist with department projects as needed.
RESPONSIBILITIES

• Partners on and/or leads projects as assigned by leadership.
• Supports the training and business operations teams as a Subject Matter Expert, including the development of desk-level procedures, root cause analysis of claims workflows, and processing issues.
• Supports claim audits in collaboration with the Audit Enablement team as needed.
• Assists with proper implementation of claims processing regulatory and compliance requirements; balances the requirements of multiple major commercial and government clients including performance guarantees and processing turnaround time requirements.
• Mentors, coaches, and trains the claims workforce, utilizing trends identified through assessment, leadership recommendations, and/or Quality team analysis to inform conversations.
• Serves as a team lead, assisting and supporting the claims workforce with processing questions and complex or escalated claim situations.
• Processes escalated claims as needed.
• Communicates feedback on team performance to supervisors and managers; works with Quality team to provide documented recommendations for development in systems, processes, and team performance.
• Assists supervisor in maintaining departmental standards and supports distribution of workload.

QUALIFICATIONS

• Ability to confront difficult situations and make appropriate and timely decisions.
• Strong time management and organizational skills, with the ability to multi-task while maintaining attention to detail.
• Strong interpersonal, written, and verbal communication skills.
• Ability to interpret, develop and ensure adherence to enterprise and departmental policies and procedures.
• Excellent customer service skills with ability to evaluate and respond to the contact needs.
• Skill in critical thinking and analysis.
• 5+ years of experience w/High School

Licenses

• Six Sigma Green Belt Certification. within 1 Year Pref'

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. $41,000 - $83,200
ADDITIONAL INFORMATION
Rewards to make you smile! We don't just want to make our customers happy - we want to give our employees a reason to smile, too. Delta Dental's comprehensive benefits package includes:

• Social responsibility and volunteer opportunities, including 16 paid volunteer hours annually
• Low-cost premium medical insurance options
• Fertility and diabetes benefits
• Employee discount program: AT&T/Verizon, entertainment, travel, and more!
• Generous 401(k) matching and flat contribution
• Culture of learning: career development and tuition reimbursement
• 100% paid dental and vision insurance
• Career growth: we love promoting from within
• Generous paid time off plus 12 holidays and your birthday off!
• Employee LiveWell program, focusing on overall employee well-being

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
#LI-Hybrid
ABOUT THE TEAM
At Delta Dental, our success is only as strong as the people who execute it! We take enormous pride in being the nation's most recognized and widely-used provider of dental insurance - and we've come this far by living our core values of innovation, excellence, service and trust. Our vision is to motivate and empower every employee so that we're all inspired to take exceptional care of our customers, providers and ourselves. We believe in integrity, accountability, collaboration, and giving every employee equitable opportunity for their voice to be heard and development to be fostered.
If you're excited about the prospect of transforming the future of health care and growing in your career, join our smile revolution!
To see some of the smiling faces behind Delta Dental and to learn more about what our values and culture look like in action, connect with us on social media: Delta Dental Ins. on Facebook and Instagram, #LifeatDDins on Facebook and Instagram, Delta Dental Ins. on Twitter and Delta Dental Ins. on LinkedIn.
We are part of the Delta Dental Plans Association, a network of companies that provides dental coverage to 74 million people in the U.S. Delta Dental of California, Delta Dental of New York, Inc., Delta Dental of Pennsylvania and Delta Dental Insurance Company, together with our affiliate companies, form one of the nation's largest dental benefits delivery systems, covering 33 million enrollees. All of our companies are members, or affiliates of members, of the Delta Dental Plans Association, a network of 39 Delta Dental companies throughout the country.
Delta Dental is an equal opportunity employer. We are committed to building and maintaining a diverse and inclusive workplace for all employees. Applicants will not be discriminated against because of race, color, religion, creed, national origin, ancestry, citizenship status, sex (including pregnancy), sexual orientation, gender or identity expression, age, disability, marital status, medical status, veteran status or any other status protected under federal, state, or local law. In addition to federal law requirements, Delta Dental complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
Unfortunately, our Delta Dental Enterprise is unable to hire individuals residing in Alaska, North Dakota, Nebraska, Hawaii, Oklahoma, Vermont, Maine, West Virginia, New Hampshire, Wyoming, Puerto Rico or other US Territories at this time.
Proof of eligibility to work in the United States must be provided if selected for hire.

• Delta Dental includes: Delta Dental of California, Delta Dental Insurance Company, Delta Dental of Pennsylvania, and Delta Dental of New York