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Billing Specialist 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 Billing Specialist uses a broad knowledge of multiple business areas (Enrollment, Accounts Receivable, Configuration, Onboarding) to track and perform premium reconciliations for payment received against invoice amount billed. This position is also responsible for analyzing premium back-up, resolving outstanding balances, and overall account resolution while delivering superior, consultative customer service for a wide variety of clients. This position takes the lead to audit, determine root cause for issues and deviations requiring manual intervention, recommends and executes action items to resolve them directly with the client.

How you will make an impact:


  • Ensures accurate billing for all cycles (weekly, biweekly, monthly billing, etc.) including creation and processing Statement of Accounts (SOA) and Stabilization of Claims utilization; Performs comparison analysis before invoices release to client and resolves identified discrepancies.

  • Provides guidance to internal and external customers on various items related to billing and reconciliation, including configuration, retroactive policy, aging balances, and impacts. When errors occur, provides feedback and recommendations to management for resolution.

  • Reviews transaction discrepancies (TRX Compare/Revenue Analysis) and prepares ACH Debit reports; Performs quality assurance of reports and analyzes and resolves exceptions as needed.

  • Analyzes and creates custom reporting and claims validation for accounts; Works with AR team to determine journal entry accruals.

  • Performs discovery audits for each group assigned as a baseline including gathering payment, billing, discrepancy, and adjustment information and determining based on this history and pattern any root cause issues that cause the account to require manual intervention.

  • Develop and execute action plans taking the lead to move customers to standard processing without manual intervention

  • Recommend, document and gain approvals for non-standard processes to be included in contracts.

  • Performs all manner of reconciliations, reclass and refunds in Oracle and ad-hoc (manual) as needed; Reviews detailed payment backup analysis for discrepancies using Bump & Compare/Vlookup.

  • Analyzes group remittance and provides guidance to AR for accurate payment application; Prepares documentation for internal and external stakeholders as needed and reviews dunning letters for propriety before sending to client.

  • Prepares Escalations, documenting timelines, actions taken and summarization of issue for Senior leadership to review.

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

What we look for:


  • 3+ years of experience w/High School Diploma.

  • 2+ years of related experience in a billing and reconciliation role preferred.

  • Positive documented experience with high profile, sensitive clients required.

  • Strong organizational/time management skills and multi-tasking abilities.

  • Detail-oriented with strong analytical and problem-solving skills.

  • Effectively able to adapt to change and be comfortable handling risk and uncertainty.

  • Ability to prioritize and manage duties in order to meet goals and deadlines.

  • Strong customer service skills; customer-focused with ability to empathize with customer.

  • PC literacy required; MSOffice skills (Outlook, Word, Excel, PowerPoint).

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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