What are the responsibilities and job description for the Eligibility Representative position at Delta Dental of Washington?
Our Eligibility Representatives provide new group set up and maintain accurate eligibility records for clients to ensure efficient and accurate premium reconciliation. This role researches and finds answers to complex client or internal questions, as well as following up on frequent, incoming inquiries regarding the processing of eligibility and premiums.
We seek a professional and organized individual with a customer service approach and problem-solving mindset to join our team. The individual must be able to work well independently as well as with an integrated team.
At Delta Dental of Washington our vision is that all people can enjoy good oral and overall health, with no one left behind. We succeed because of a shared commitment to a set of values that guide everything we do – for our customers, for our communities, and for each other. We are Accountable. We lean in with Courage. We stay Curious. We are Inclusive. We act with Integrity.
We offer a highly competitive medical, dental and vision plans as well offering an 8% 401k match and all employees start accruing vacation and sick time from their very first day. We empower employee development through our tuition reimbursement plan, professional development plans, and employee-led communities.
The pay range for this position varies between $39,520.00 – $45,570.00. Washington Dental Service and its affiliates, including Delta Dental of Washington and Arcora Foundation, intends to offer the selected candidate a base pay within this range, dependent on job-related, non-discriminatory factors such as experience. Base pay will also be adjusted based on the candidate's geographic location.
Essential Responsibilities include the following: The list of responsibilities listed is not intended to be comprehensive. Washington Dental Service and its affiliates, including Delta Dental of Washington and Arcora Foundation reserve the right to change the responsibilities at any time with or without notice.
- Research and provide accurate and timely responses to internal and external inquiries regarding eligibility via telephone and written correspondence
- Assist in identifying problem areas and recommend solutions when necessary
- Reconcile premiums to client reporting and assist Finance in group premium distribution
- Set up and process eligibility updates through data entry functions
- Review, correct and process electronic files
- Provide education to group representatives regarding eligibility requirements
- Conduct site visits for groups and group administrators
- Request to have claims processed for payment after the subscriber database is accurately updated and premiums are reconciled
- Develop and maintain positive relationship with our groups
- Ability to multi-task, maintain workloads efficiently, and prioritize assignments appropriately.
- Participate in meetings and training sessions in a positive, professional and open-minded manner.
- Perform other duties as needed
Experience, skills, and education do you need to succeed in the position: The requirements listed below are representative of the knowledge, skill, and/or ability required to successfully perform the essential functions of the position.
- Strong verbal and written communications skills, including professional, client-appropriating correspondence.
- Demonstrated computer skills, particularly speed and accuracy in data entry.
- Detail oriented with a high level of accuracy.
- Strong organizational skills and ability to prioritize.
- Flexible work style to adapt to independent or teamwork.
- A high school diploma or general education degree (GED) is required for this role. At least one-year insurance eligibility or billing/accounts receivable experience is preferred.
Washington Dental Service and its affiliates, including Delta Dental of Washington and Arcora Foundation is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)
