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Eligibility Representative I

Delta Dental of Washington
Spokane, WA Full Time
POSTED ON 3/2/2025
AVAILABLE BEFORE 4/27/2025

Our Eligibility Representatives I provide new group set up and maintain accurate eligibility records to ensure accurate premium reconciliation.  This role researches and finds answers to 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 a generous 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 In Western Washington varies between $39,520.00 – $49,650.00, and for Eastern Washington varies between $40,560.00 - $48,575.00. 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 Arcora Foundation, Delta Dental of Washington, and TriForza 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
  • Processes Dental and Vison eligibility updates for Billing and Online Groups through data entry
  • Log on to HealthLogic website to review correspondence and process enrollments and updates assigned
  • Log on to VSP Portal to verify/confirm eligibility for members with vision benefits
  • Assist the Finance Department with premium and payment inquiries
  • Create a call tracking to have claims reprocessed, histories transferred or incentive levels updated
  • Provide education to group representatives regarding eligibility requirements
  • Attend site visits for Groups, Brokers and Third Party Administrators
  • Develop and maintain positive relationship with our Groups, Brokers and Third Party Administrators
  • 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
  • Assist in identifying problem areas and recommend solutions when necessary
  • Perform other duties as needed

Experience, skills, and education needed 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 Arcora Foundation, Delta Dental of Washington, and TriForza are Equal Opportunity employers. 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.

    Salary : $39,520 - $49,650

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