What are the responsibilities and job description for the Operations Support Specialist position at Delta Dental of Kentucky, Inc?
Delta Dental of Kentucky is looking for a dynamic individual to fill the role of Operations Support Specialist in our Louisville, Kentucky office.
Job Summary
To provide data entry, clerical, mailroom, and fulfillment support to the operations departments.
Primary Job Responsibilities
- Administer, analyze, adjudicate and process claims in accordance with benefit contracts and plan policies; assist department to resolve more complex claim issues; maintain claim records. Work closely with other departments for any inquiries regarding claims processed.
- Maintain required production and quality standards as established by the department and contribute to the accomplishment of team goals.
- Provide clinical review of pre-authorization claims or prepares claims for Dental Consultant review based on the procedures submitted. Work directly with the Dental Consultant to resolve issues and determine benefit.
- Provide character correction of claims or other documents submitted from customers or providers into our processing system which consists of assisting the Claims Department with OCR processing and/or claims processing worklist, as needed or when mail volume is low.
- Open mail to prepare for sorting, prepping, and counting of incoming daily mail.
- Scan prepared claim batches into Optical Character Recognition system for claims processing; scan prepared customer service documents into system for processing.
- Collect and meter outgoing mail; prepare/ship packages and mail using appropriate vendor and cost center; verify that items are addressed correctly, marked with the proper postage, and in suitable condition for processing.
- Separate and deliver incoming mail, packages, and interoffice mail by individual.
- Serve as backup to other team members within departments and Fulfillment.
Perform other related assigned duties as necessary to complete the Primary Job Responsibilities as described above.
Minimum Qualifications
Position requires a high school diploma or equivalent and three years' experience working in a claims, medical, or dental related position. Will accept any suitable combination of education, training, or experience.
Position requires advanced PC keyboarding and Windows-based program experience; multitasking with the ability to work in different job functions and areas.
Delta Dental of Kentucky, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, or veteran status.
Position requires a high school diploma or equivalent and three years' experience working in a claims, medical, or dental related position. Will accept any suitable combination of education, training, or experience.
Position requires advanced PC keyboarding and Windows-based program experience; multitasking with the ability to work in different job functions and areas.
Delta Dental of Kentucky, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, or veteran status.
