Edi And Billing Coordinator

Delta Dental of New Jersey, Inc., located in Parsippany NJ has an immediate opportnituy for an EDI and Billing Coordinator to perform diversified duties regarding eligibility verification and processing functions to ensure accurate records necessary for billing and claims adjudication purposes. This is a hybrid position, in office Wednesdays plus one other day during the week, and remote three days. In addition to the criteria noted below, the individual we're seeking for this position will be adaptive and curious, oriented to change, have a proven track record of executing on deliverables.

We offer a competitive compensation and benefit package including medical, dental, Rx and vision, matching 401k, STD/LTD, life insurance and tuition reimbursement, as well as generous PTO. Come join a great team and get your smile on.

Essential Functions & Responsibilities

• Reviews, evaluates, and enters eligibility adjustments and updates into the eligibility system or capitation system accordingly.
• Prepares correspondence/reports for group administrators and/or brokers regarding eligibility situations.
• Assists with loading one time load and Open Enrollment spreadsheets.
• Responds and follows up with benefit administrators/Brokers/TPA’s by telephone and/or e-mail to verify eligibility, report problems with an electronic file. In addition, responds to eligibility and Billing questions.
• Processes corrections from the electronic group data.
• Handles billing inquiries by providing exceptional service via telephone and corresponding with benefit administrators/Brokers or TPA’s.
• Researches and resolves billing errors in a timely manner.
• Participate in new Client implementations.
• Create and Maintain Media Profiles
• Create and Maintain Global-Scape accounts and contacts.
• Proactively reach out to clients/vendors regarding system access
• Create and Maintain Web-Methods accounts and contacts
• Assist with resolving file failures.
• Support ticket/issue resolution
• Support file testing
• Work collaboratively with key stakeholders
• Assist with daily dropping of finals.
• Performs account audits upon request.
• Other duties as assigned

Essential Qualifications

Competencies

Adaptability/Flexibility

Communication

Computer Skills

Customer Focus

Dependability

Job Knowledge

Productivity

Quality

Teamwork

Knowledge, Skills & Abilities

Technical and Functional

• Ability to work effectively with benefit administrators, brokers, vendors, and staff members
• Excellent verbal and written correspondence skills
• Excellent Excel skills
• Good keyboard skills
• Strong math aptitude
• Good analytical ability
• Ability to handle multiple priorities/tasks simultaneously and with composure.
• Ability to make decisions independently within a framework of established general directions
• Must possess a positive attitude and the ability to work cooperatively in a team environment
• Above average ability to retain knowledge toward claim processing system, eligibility system and group contact eligibility requirements

Required Physical Abilities

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Ability to sit and perform extensive close keyboard and PC work including data entry
• Ability to walk, talk or hear
• Occasionally required to stand and reach with hands and arms

Working Environment

• Ability to meet deadlines and attendance standards.
• The noise level in the work environment is usually moderate.
• This classification will be required to sign a confidentiality agreement

Experience, Education and Certifications Required

Experience Required

• Minimum one (1) year clerical experience, insurance industry preferred
• Experience in Enrollment and Billing environment a plus

Required Educational Level