About the position
The Enrollment & Billing Specialist plays a crucial role in managing the end-to-end account processing and maintenance for Delta Dental. This position is responsible for validating enrollment applications, entering enrollment information into the system, and analyzing billing against payments received. The specialist will resolve outstanding balances by reviewing and analyzing documented findings, billing contract information, and systems data to ensure that accounts are accurate and current. This role requires a keen attention to detail and the ability to work collaboratively with various internal departments to ensure timely and accurate invoicing and resolution of billing and reconciliation issues. Key responsibilities include performing billing and reconciliation activities, identifying and documenting sources of variances, and working with internal departments to determine resolutions. The specialist will also resolve outstanding aging balances for accounts, utilizing knowledge of business systems and their relationship to contract analysis, invoicing, and collection processes. In cases of complex billing and account issues, the specialist will escalate these matters to the coordinator or management as necessary. Continuous follow-up on open items, including resolution status with other departments, is essential, especially for accounts that may move into the delinquent category. The Enrollment & Billing Specialist will establish effective partnerships and working relationships with relevant internal departments such as Sales, Eligibility, and Accounting. This collaboration is vital for ensuring timely and accurate invoicing and the resolution of billing and reconciliation issues. The role also involves preparing timely and accurate billing and reconciliation reports, validating the authenticity of proof-of-eligibility documentation submitted by subscribers, and making decisions on enrollment applications. The specialist will review, investigate, and track all requests for retroactive enrollments, ensuring that discrepancies are identified and resolved efficiently. Additionally, the specialist will gather and reconcile monthly enrollment activity data and process enrollment prepayment checks and credit card charges.
Responsibilities
- Validating enrollment applications and entering enrollment information into the system.
- Analyzing billing against payments received and resolving outstanding balances.
- Performing billing and reconciliation activities and identifying sources of variances.
- Working with internal departments to determine resolutions for billing issues.
- Resolving outstanding aging balances for accounts using knowledge of business systems.
- Escalating complex billing and account issues to coordinator or management as required.
- Continuously following up on open items and resolution status with other departments.
- Establishing effective partnerships with internal departments to ensure timely invoicing.
- Preparing timely and accurate billing and reconciliation reports as required.
- Validating authenticity of proof-of-eligibility documentation submitted by subscribers.
- Approving and/or rejecting enrollment applications.
- Processing enrollment information of new customers and ensuring accurate setup.
- Reviewing and investigating requests for retroactive enrollments.
- Identifying and resolving applications with discrepancies and tracking their status.
- Gathering and reconciling monthly enrollment activity data and processing payments.
Requirements
- 1+ years of experience with a High School diploma.
- 2+ years' related experience preferred.
- Strong analytical and problem-solving skills.
- Detail-oriented with strong organization and planning skills.
- Knowledge of Delta Dental policies, procedures, and guidelines.
- Ability to independently prioritize work and follow work rules and procedures.
- Maintains strict patient confidentiality and adheres to HIPAA guidelines.
- Ability to confront difficult situations and make timely decisions.
- Strong customer service skills and effective communication abilities.
- Basic mathematical skills.
Nice-to-haves
- Experience in the dental or healthcare industry.
- Familiarity with billing software and systems.
- Knowledge of HIPAA regulations and compliance.
Benefits
- Competitive base and incentive pay
- 401(k) with robust matching and non-matching contributions
- Rich medical & pharmacy benefits
- 100% employer-paid dental and vision benefits
- Holistic wellbeing program with financial incentives
- Generous paid time off plus 12 paid holidays and your birthday off
- Career development opportunities and tuition reimbursement
- Adoption assistance and fertility treatment support
- Child, elder, and pet care assistance
- Social responsibility and volunteer opportunities
- Employee discount program
