Delta Dental of Michigan

Delta Dental of Michigan 27500 Stansbury Rd, Farmington Hills, MI 48334
Dec 06, 2018
Full time
Job Summary: To assist management in determining compliance with performance and quality control standards. Identifies, analyzes, and recommends process improvements that will result in increased quality and efficiency.   Primary Job Responsibilities:   Samples, compiles, and analyzes data to determine compliance with quality, production, and performance standards and develops, prepares, maintains, and distributes reports for productivity and quality control. Recommends and develops quality control programs and procedures. Verifies that department documentation is current and supports quality guidelines. Maintains departmental process and procedure documentation, including compliance and ISO documentation and maintains the departmental intranet sites. Identifies, analyzes, and recommends process and/or operational improvements to enhance efficiency, quality, and operational effectiveness. Partners with trainer and management on trends identified through the quality monitoring process. Provides feedback to assist management in coaching and developing staff.  Recognizes and communicates development needs of employees and assists trainers and management with employee training programs as needed.   Perform other related assigned duties as necessary to complete the Primary Job Responsibilities as described above.   Job Requirements:   Position requires an associate's degree, technical, vocational, or business school with coursework in business administration and two years' work experience in a customer service and/or claims processing environment. Will accept any suitable combination of education, training, or experience.   Position requires knowledge of dental terminology, procedures, insurance products, and claims processing; advanced knowledge of word processing and spreadsheets; ability to identify weaknesses in process changes that may affect quality; resolves complex problems and uses latitude for independent judgment; effective verbal and written communication skills and organizational skills; ability to collaborate effectively; ability to handle multiple projects and deadlines; recommends improvements to increase quality and efficiency; SharePoint experience is preferred.   All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.
$15.85 hourly
Delta Dental of Michigan 27500 Stansbury Rd, Farmington Hills, MI 48334
Dec 06, 2018
Full time
TYPICAL ASSIGNMENTS In a developing and learning capacity, the Trainee will perform the following typical assignments: *Researches inquiries by accessing the claims processing system and other informational sources *Responds to customer/group and provider questions through telephone contact and/or written communication (such as mail) using proper etiquette, grammar, punctuation, etc. *Maintains related departmental records and files *Operates office equipment which may include a personal computer, calculator, copier, fax machine, etc. *Makes corrections to claims and eligibility *Enters new claims, eligibility and subscriber information into the mainframe *Reviews subscriber's coverage to determine type and level of benefits   Job Requirements:   *Possess a high school diploma or equivalent *One year of customer service experience in a business environment that requires the use of a computer program to assist the customer, preferably in a call center, and/or dental experience *Successful completion of the customer service simulation test (minimum score of 62 out of a possible 100) (assessment waived if candidate previously passed test while at Delta Dental or if previously held Customer Service Trainee, Customer Service Advisor or Customer Service Associate position) *Employees bidding the first shift must have the ability to begin work 8:25 a.m. or work until 6:30 p.m., Monday through Friday *Employees bidding the second shift must have the ability to begin work at 11:00 a.m. or work until 12:00 Midnight, Monday through Friday All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.