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EDI Analyst at Delta Dental of California

Posted in Other 30+ days ago.

Location: Mechanicsburg, Pennsylvania





Job Description:

At Delta Dental, our strategy is only as strong as the people who execute it! We are hiring individuals that are not just right for today but also for our future. We have built a foundation of high-trust by treating all people with dignity, making and keeping commitments, and consistently striving to do the right thing. Our leaders optimistically share future possibilities to inspire and motivate others toward their full potential. We expect our employees to find ways to embrace positive change, be curious and challenge the status quo, and provide solutions to unmet problems. Joining Delta Dental means joining a culture focused on fostering development, building genuine connections, recognizing each other's strengths and sharing in successes.
The EDI Analyst is responsible for all aspects of the exchange of EDI eligibility feeds from our external customers, as well as representing the business for eligibility. This position manages the day-to-day processing of electronic enrollment files, ensuring accuracy and researching file issues/failures when they arise. The incumbent in this role is an integral liaison between internal departments and external contacts as it relates to enrollment.

How you will make an impact:


  • Liaison between the enterprise and external customers in the exchange of EDI; respond to and resolve client inquiries and questions.

  • Ensure the customer understands potential impact and risks of data quality deficiencies and deviations from standards; create plans of action with the customer to improve data quality and adherence to standards.

  • Receive and review data, resolving minor reformat conversion issues utilizing the EEP infrastructure; ensure all files are accurately loaded in a timely and accurate manner

  • Research, analyze and resolve file feed failures; work with EDI Analyst Senior team if assistance is needed.

  • Perform periodic regression testing and post-implementation reviews to recommend system and/or file conversion enhancements that would result in increased efficiency of the EEP application at the customer level.

  • Evaluate file parameter settings on a regular basis to ensure data integrity.

  • Serve as the subject matter expert for assigned electronic eligibility feeds; actively participate in conference calls with assigned groups and acts as the representative of enrollment.

  • Maintain a process improvement mindset, analyzing processes and recommending improvements as needed.

  • Support product development where there is an EDI impact, attending/participating in conference calls, and gathering requirements; consults EDI Analyst Sr team as needed.

  • Collaborate with Billing Analyst team members on resolving premium/eligibility reconciliation issues in a timely manner .

  • This list is not all-inclusive and you are expected to perform other duties as requested or assigned.

What we look for:


  • 2+ years of experience with Bachelor's or a minimum of 2 years electronic transactional environments.

  • Strong analytical, logical reasoning, and problem-solving skills.

  • Ability to work independently and make decisions.

  • Knowledge of and experience with ANSI standards.

  • Knowledge of electronic transaction from both validation and translation perspective.

  • Good organizational and time management skills with the ability to adhere to deadlines.

  • Ability to multi-task while maintaining excellent attention to detail.

  • Ability to maintain confidentiality.

  • Strong interpersonal, written and verbal communication skills.

  • Ability to interact well with management, all levels of employees and outside contacts including vendors, consultants, auditors, etc.

  • Excellent customer service skills.

Benefits and perks:


  • 12 days starting vacation, 12 holidays, 9 sick days and your birthday off!

  • Low-cost premium medical insurance options

  • 100% paid dental and vision insurance

  • Generous 401(k) matching and flat contribution

  • Social responsibility and volunteer opportunities, including 16 paid volunteer hours annually

  • Employee LiveWell program, focusing on overall employee well-being.

  • Fertility and diabetes benefits

  • Employee discount program: AT&T/Verizon, entertainment, travel, and more!

  • Culture of learning: career development and tuition reimbursement

  • Career growth: we love promoting from within

Due to COVID-19, there is an even greater demand for flexibility and change. As Delta Dental navigates our Return-to-Office strategy, the expectation around work location for certain roles may be offsite until a future date, determined by Delta Dental Management. Should the position you seek be determined by Delta Dental Management to begin your duties offsite, the position would require you to have access to internet in order to meet the expectations outlined in the job duties.
Please note, Delta Dental will not sponsor applicants for work visas for this position.
#LI-SS1
At Delta Dental we:Promote accountability, integrity and collaboration: Our employees are collaborative, self-aware, and ethical. It is our expectation to do the right thing and follow through on commitments.Foster professional development: Our employees take ownership of developing themselves and others through coaching, mentoring and providing/being open to constructive feedback and identifying learning opportunities.Value customers and cultivate positive experiences: Our employees take time to build rapport with customers, while anticipating and exceeding their needs to ensure positive outcomes.
If you think this sounds like you, let's chat. We would love to tell you more!
To see some of the smiling faces behind Delta Dental and to learn more about what our values and culture look like in action, connect with us on social media: @lifeatddins on Facebook and Instagram, @deltadentalins on Twitter, and Delta Dental Ins. on LinkedIn. ABOUT Delta DentalDelta Dental covers more Americans than any other dental benefits provider. Our vision is to motivate and empower every employee so we're all inspired to take exceptional care of our customers, providers and each other. Our Enterprise Strategy focuses on pillars of Growth and Diversification, supported by the platforms of Culture and People, Process and Technology. Our employees take pride working for a purpose-driven organization and live our values of Trust, Service, Excellence and Innovation. We are part of the Delta Dental Plans Association, a network of companies that provides dental coverage to 74 million people in the U.S. Delta Dental of California, Delta Dental of New York, Inc., Delta Dental of Pennsylvania and Delta Dental Insurance Company, together with our affiliate companies, form one of the nation's largest dental benefits delivery systems, covering 33 million enrollees. All of our companies are members, or affiliates of members, of the Delta Dental Plans Association, a network of 39 Delta Dental companies throughout the country. Delta Dental provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, genetics, or any other classification protected by federal or state law. In addition to federal law requirements, Delta Dental complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
Unfortunately, our Delta Dental Enterprise is unable to hire individuals residing in Alaska, North Dakota, Nebraska, Hawaii, Oklahoma, Vermont, Maine, West Virginia, New Hampshire, Wyoming, Puerto Rico or other US Territories at this time.
Proof of eligibility to work in the United States must be provided if selected for hire.
As a Federal Contractor, we require all employees to be fully vaccinated for Covid-19. You will be required to provide proof of full vaccination upon hire or obtain approval of a valid medical or sincerely held religious exemption from receiving a Covid-19 vaccine prior to your start date.
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