Professional Relations Coordinator

Delta Dental of WI•Stevens Point, WI

1d•Onsite

About The Position

Join Delta Dental of Wisconsin Delta Dental of Wisconsin is seeking a Professional Relations Coordinator to assist our Professional Relations Team. This position is responsible for tasks including provider record maintenance, credentialing, preparing reports, selected review claim processing and supporting the Professional Relations teams, including workflow management and arranging logistics for department events. This is an excellent opportunity to expand your skills and gain cross-functional experience. We offer a collaborative work environment, comprehensive benefits, and ongoing professional development opportunities.

Requirements

Associate degree in a related business field and two years’ experience in a business setting or equivalent combination
Participate in ME verification processes to ensure secure and authenticated access to the National Provider Database
Demonstrated proficiency with MS Office Suite applications
Ability to effectively and efficiently prioritize and execute multiple tasks
Experience working in a fast-paced, team-oriented, collaborative environment
Strong interpersonal, written and oral communication skills
Strong customer service orientation
Ability to make decisions and use good judgment when working independently
Ability to operate a computer keyboard, mouse and other office equipment

Nice To Haves

Experience within the Insurance industry, or knowledge of dental business is preferred

Responsibilities

Provide timely and accurate support through the Professional Relations phone queue and Professional Relations Coordinator inbox by addressing inquiries from dental offices related to provider agreements, fees, and claim reviews.
Develop and maintain provider records
Execute credentialing processes for all providers to ensure compliance with DDPA, NCQA, and CMS requirements, which includes accessing the National Provider Database
Perform functions as NPF Administrator and/or NPF Alternate
Assist with the completion of vital DDPA NPF tasks such as: Error reports remediation Annual Directory Accuracy Audit
Perform processes related to 1099 records
Administer review claims according to provider claim and code holds
Maintain claims identified on 900 and OT report; contact dental offices for follow-up as
Prepare filed fee updates for data entry
Create and maintain process and procedure documents.
Coordinate assigned support activities for meetings, conferences and department activities