Professional Relations Coordinator

Johnston, IA (http://maps.google.com/maps?q=9000+Northpark+Drive+Johnston+IA+USA+50131)

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Job Type

Full-time

Description

Come Smile with Us!

Are you detail-oriented and passionate about ensuring quality and accuracy in your work? Delta Dental of Iowa seeks aProfessional Relations Coordinatorto maintain our provider file database. This role is vital in supporting both commercial and government programs by building provider records, credentialing, maintaining fee schedules, conducting system testing, quality assurance, and ensuring web feed accuracy. You will also communicate with providers on items related to enrollment, credentialing, National Provider File and internal system set up, and other essential needs. If you’re ready to make an impact while supporting healthcare initiatives, we want to hear from you! This hybrid position is located in Johnston, Iowa.

Learn whyShannon (https://youtu.be/1TyPl9PaAg0?si=1ApdEeR7Pp5smRkk) enjoys working in this role.

Why Delta Dental of Iowa?

For your smile. For your health. For your community.

At Delta Dental of Iowa, we’re more than just a dental and vision insurance company. Improving health and wellness is at the center of everything we do. As a not-for-profit, we aim to build stronger communities by investing in actions that promote and improve health. Delta Dental of Iowa invests 40% of our dollars directly back into the communities we serve.

Come see why we are passionate about "Bringing Smiles" to our customers. Our team enjoys competitive pay and benefits, an awesome "One Team" approach, and a company culture that fosters "Exceptional Quality Service" and "Leadership at All Levels." Together, we can make a difference – not only in Iowa but across the country.

Essential Functions and Principal Accountabilities:

• Maintain the National Provider File database, manage provider data, build provider records, credential new providers, re-credential existing providers, maintain fee schedule and ensure data feeds to website are accurate.

• Monitor Iowa Dental Board actions.

• Test systems changes and provide input into potential issues. Monitor provider content on our website and the dental portal. Perform quality assurance on the provider file, communicate with providers to verify information and rectify any discrepancies.

• Serve as point of contact to resolve provider issues with other Delta Dental Plans Association (DDPA) member companies for providers outside of Iowa.

• Respond to audit requests from DDPA, Medicaid and other internal and external entities.

• Research and resolve escalated provider inquiries related to credentialing, board actions or related to provider set up within our system.

• Update procedure manuals and process documents, partner with compliance to ensure all laws and regulations are up to date and properly recorded. Assist with Request for Proposal (RFP) responses regarding the provider network.

• Run, test and implement business objects reports.

• Run reports including network counts.

• Work with Technology and Operations departments to test codes, analyze errors, develop solutions or work-arounds.

• Complete special projects as assigned.

• Perform other duties as assigned.

Requirements

• Bachelor’s degree or three to five years of combined experience in provider network maintenance and/or customer service.

• Experience in administrative functions with a strong metric-driven, technical focus is preferred.

• Demonstrated ability to identify, research, and resolve issues by making sound decisions in accordance with policies and procedures.

• Excellent organizational skills and attention to detail.

• Excellent written and verbal communication skills.

• Ability to interact with internal and external stakeholders in an effective and positive manner.

• Demonstrated competency in computer skills, including Microsoft Excel and Word. Database/data warehouse environments experience preferred.

• Demonstrated ability to prioritize and function effectively with multiple tasks/assignments.

• Ability to analyze information and make independent decisions.

• Ability to work independently or as part of a team to complete assigned tasks and achieve goals.

• Competency in basic math ability.

Delta Dental of Iowa is an Affirmative Action and Equal Opportunity Employer committed to providing equal employment opportunity for all persons without unlawful regard of race, color, religion, sex, sexual orientation, gender identity, age, national origin, individuals with disabilities, protected veteran status, or any other legally protected basis.

EEOC Poster (https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf)