LogoFresh Jobs Ahead
Liberty Dental Plan
Liberty Dental Plan
1.001 – 5.000 Angajați
Asistență medicalăConsultanțăLogistică
Liberty Dental Plan este o companie de servicii medicale cu sediul în SUA, care administrează programe de asigurare dentară pentru Medicaid, inclusiv Medi-Cal, Medicare Advantage, piețe comerciale, persoane fizice și familii, precum și piețe de grup în mai multe state. Serviciile sale sprijină membrii prin instrumente de căutare a medicilor dentiști, un portal pentru membri, acces mobil și resurse pentru solicitări de despăgubire și eligibilitate. Furnizorii pot utiliza instrumente dedicate pentru înscrierea în rețea, transmiterea solicitărilor, îndrumare clinică și programe de îngrijire bazate pe valoare. Activitatea companiei include administrarea beneficiilor stomatologice, gestionarea rețelei de furnizori, conformitatea, acreditarea și sprijinirea membrilor, cabinetelor stomatologice și brokerilor.
LinkedIn
Locurile de muncă ale companiei

System Configuration Analyst, Dental Claims

Configure and test dental claims and utilization management systems at Liberty Dental Plan. The role focuses on benefit logic, claims rules, audits, and member notifications.

USStatele Unite ale Americii
65.000 $ – 75.000 $ / an
RemoteNormă întreagăJuniorNivel mediuLimbă Obligatorie: englezăAnalist

Descriere

  • Manage claims and utilization management projects from coordination through completion.
  • Review and process complex claims and utilization management cases.
  • Help implement benefits and configure claims and utilization management systems.
  • Work with cross-functional teams to build and maintain member notifications about claims and utilization management decisions and outcomes.
  • Contribute to research and new business implementation projects as needed.
  • Work with managers to develop, revise, and maintain departmental policies and procedures.
  • Review and test existing system code rules, then recommend improvements.
  • Test new and existing benefit configurations used in claims and utilization management adjudication.
  • Assist with implementing Crystal Reports for claims and utilization management work.
  • Carry out other assigned duties.

Cerințe

  • Bachelor’s degree.
  • At least two years of experience in PPO or HMO claims processing, billing, or auditing.
  • Proficiency with Microsoft Word, Excel, and Access.
  • Strong written and spoken communication and presentation skills.
  • Advanced analytical abilities, including data mining, reporting, and analysis.
  • Sound judgment and logical reasoning, with the ability to communicate effectively in varied circumstances.
  • Ability to manage multiple tasks efficiently amid interruptions or competing priorities.
  • Knowledge of HSP systems.
  • Knowledge of dental procedures.
  • Knowledge of HSP denial explanations.
  • Knowledge of service restrictions.
  • Basic data analytics experience.
  • Auditing experience preferred.
  • Must be able to work in the United States.
  • Visa sponsorship is not available at this time.

Beneficii

  • Competitive compensation structure and savings options.
  • 401(k) plan with employer matching, Roth IRA options, immediate vesting during the Safe Harbor period, and access to professional financial advice through Financial Engines.
  • Affordable medical insurance, including low-cost employee-only premiums.
  • Dental coverage for employees and eligible dependents paid in full by the company.
  • Vision insurance with low-cost premiums for employees and dependents.
  • Company-paid basic life and AD&D coverage equal to one year of base salary, with the option to buy additional coverage.
  • Flexible Spending Accounts for healthcare and dependent care.
  • Optional accident, critical illness, and hospital indemnity coverage.
  • Long-term disability insurance.
  • Wellness programs, including company-wide challenges, BurnAlong memberships, and gym discounts.
  • Employee Assistance Program for mental health and well-being support.
  • Generous vacation and sick leave, with the ability to carry over unused time.
  • Ten paid company holidays.
  • Tuition reimbursement for eligible education expenses.
  • Remote or hybrid work options are available for various positions.

Locuri de muncă similare

ANGEHEUERT ⚓ | Recruiting as a Service & Employer Branding

Area Sales Manager, Sustainable Smart Locker Network

ANGEHEUERT ⚓ | Recruiting as a Service & Employer Branding
11 – 50 Angajați
ConsultanțăLogisticăMarketing
DEGermaniaHibridNormă întreagăJuniorNivel mediuNu este necesară o diplomăLimbă Obligatorie: germanăVânzări

Expand a sustainable smart locker network by developing B2B partnerships across grocery retail, fuel stations, and housing. The role combines regional field sales with customer management from first contact to contract.

Deschide