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Manager Claims Processing

Company: Delta Dental
Location: Rancho Cordova
Posted on: May 3, 2021

Job Description:

At Delta Dental, our strategy is only as strong as the people who execute it! We are hiring individuals that are not just right for today but also for our future. We have built a foundation of high-trust by treating all people with dignity, making and keeping commitments, and consistently striving to do the right thing. Our leaders optimistically share future possibilities to inspire and motivate others toward their full potential. We expect our employees to find ways to embrace positive change, be curious and challenge the status quo, and provide solutions to unmet problems. Joining Delta Dental means joining a culture focused on fostering development, building genuine connections, recognizing each other's strengths and sharing in successes. The Manager Claims Processing is responsible for managing the day-to-day operations of the Claims Processing function to ensure that the quality and quantity meets or exceeds the established service goals. The Incumbents' responsibilities include the efficient handling of inquiries from internal and external sources, client and/or subscribers and the management of human and technical resources.How you will make an impact:Manages staff including determining staffing needs, setting goals, interviewing, coaching, and evaluating the performance of all direct reports.Evaluates work/project requests to determine feasibility (cost/benefits analyses) and appropriate department resources.Ensures work and projects are completed within established schedules and budgets and takes corrective actions, as needed.Responsible for researching and selecting vendors to provide services, as needed.Ensures on-going claims processing costs are as competitive as possible, within the limits of contractual requirements. This includes identifying new technologies and enhancements to existing services and improvement of procedures.Ensures proper implementation of the claims processing regulatory and compliance requirements. Balances the requirements of multiple major commercial and government clients including performance guarantees and processing turnaround time requirements.Serves as the point of contact for claims processing with sales and account services.Supports the development of proposals to clients to increase competitive position.Develops, monitors, and reconciles an annual operating plan and budget.Provides oversight and support in responding to group and regulatory audit requests to include implementation and monitoring of corrective action plans.This list is not all-inclusive and you are expected to perform other duties as requested or assignedWhat we look for:8+ years w/Bachelor's degree; 1+ years supervisory/management.Minimum of 6 years of experience in the insurance industry, with concentration in high volume claims processing or related experience.2 years of supervisory experience; or relevant graduate degree with 1 year supervisory/management experience. Strong organizational/time management skills and ability to multi-tasks. Detail-oriented; flexible and creative. Interpersonal and communication skills to work effectively with all levels of staff. Working knowledge of claims processing flow and adjudication. Ability to interpret, develop and ensure adherence to enterprise and departmental policies and procedures. Strong leadership skills.Benefitsand perks:12 days starting vacation plus 12 holidays and your birthday off!Multiple medical insurance options: 100% paid or low cost premiums100% paid dental insurance100% paid vision insuranceEmployee well-being programCulture of learning: substantial tuition reimbursement to improve your skillsCareer growth: we love promoting from withinStrong commitment to work/life balance Social responsibility and volunteer opportunitiesDue to COVID-19, there is an even greater demand for flexibility and change. Due to the pandemic, the expectation around work location for certain roles may be remote until a future date, determined by Delta Dental Management. Should the position you seek be determined by Delta Dental Management as "remote," the position may require you to have access to remote internet in order to meet the expectations outlined in the job duties.#LI-JB1At Delta Dental we:Promote accountability, integrity and collaboration: Our employees are collaborative, self-aware, and ethical. It is our expectation to do the right thing and follow through on commitments.Foster professional development:Our employees take ownership of developing themselves and others through coaching, mentoring and providing/being open to constructive feedback and identifying learning opportunities.Value customers and cultivate positive experiences:Our employees take time to build rapport with customers, while anticipating and exceeding their needs to ensure positive outcomes. If you think this sounds like you, let's chat. We would love to tell you more!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: @lifeatddins on Facebook and Instagram, @deltadentalins on Twitter, and Delta Dental Ins. on LinkedIn. ABOUT Delta DentalDelta Dental covers more Americans than any other dental benefits provider. Our vision is to motivate and empower every employee so we're all inspired to take exceptional care of our customers, providers and each other. Our Enterprise Strategy focuses on pillars of Growth and Diversification, supported by the platforms of Culture and People, Process and Technology. Our employees take pride working for a purpose-driven organization and live our values of Trust, Service, Excellence and Innovation. 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 provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, genetics, or any other classification protected by federal or state 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.Proof of eligibility to work in the United States must be provided if selected for hire. Rancho Cordova, CA /Enterprise Operations /Full-TimeSDL2017

Keywords: Delta Dental, Rancho Cordova , Manager Claims Processing, Other , Rancho Cordova, California

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