File Maintenance Specialist

Delta Dental of Washington • Spokane, WA

6h • $42,000 - $63,000

About The Position

Creates and maintains accurate records necessary for claims processing and
adjustments of claims. This role also conducts research on the claims files as
needed. The File Maintenance Specialist further partners with Claim Examiners,
Service Specialists, Supervisors, Group Administration, Sales and other
departments to help with advanced research and questions.

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 Eastern Washington varies between $42,000.00
- $63,000.00. Washington Dental Service and its affiliates, including Arcora
Foundation, Delta Dental of Washington, and TriForza Corp. 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.

Requirements

• Friendly and professional communication skills
• Detail oriented with consistent follow-up practices and customer focus
• Ability to understand and explain Delta Dental of Washington claim information required
• Demonstrated record of being organized and able to meet deadlines
• Is a standout colleague who is willing to go above and beyond to make sure the work is accomplished timely and accurately
• Takes the initiative to identify issues and report them quickly
• A strong desire to perform well and continue to learn

Responsibilities

• Claim adjustments: including all aspects of claims
• Member updates: including accumulators, deductibles, maximums, incentive levels, clinical history, history transfers, etc. for new groups or group changes
• Projects: including ortho reset ups, provider changes, groups changes and updates, etc.
• Documentation updates for reports, projects and workarounds
• Daily/weekly Reports
• Project tickets from several different departments
• User acceptance testing
• Write up and submission requests for Accounts Payable Checks
• Priority and Out of Country Claim Submissions
• Serve as a resource and SME to supervisors, service specialists, support team, claims specialists, as well as other departments for research and assistance of claim problems, adjustments, DDWA policy, group problems, system problems, etc.
• Process ready to pay claims
• Help identify system problems, group set up errors, etc. and report to our Operations Analysts
• Outreach to provider offices, members, law firms for additional information needed to process a claim or update a member file
• Process subrogation requests

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed
• Number of Employees: 1-10 employees