Career Opportunities
Thursday, July 29, 2010


Career Opportunities

Ready for a great career move? Delta Dental of Virginia is currently recruiting candidates for the following positions:

*Unless otherwise noted, all positions are located in Roanoke, Virginia.

 

Business Systems Analyst

Job Summary:

Reviews, analyzes, and evaluates business systems and user needs. Gathers business requirements, evaluates existing application products which could address client requirements, identifies functional requirements, determines acceptance criteria and develops recommendations where appropriate. Relies on extensive experience and judgment to plan and accomplish goals. Performs a variety of tasks. May provide consultation on complex projects and is considered to be a top level contributor/specialist. 

Provides assistance and consultation on end-user ad-hoc query and reporting needs. Works directly with clients at all levels within the organization and with outside parties to identify functional requirements with sufficient detail and clarity to allow IT solution proposal development.

Job Description:

An employee in this class performs responsible technical and professional work under limited supervision. Work is performed in a team setting with multiple priorities and tasks, often working under time pressure. The employee must have the ability to develop complex written materials and design specifications for automated systems intended to fulfill corporate business requirements. Must also be able to follow complex oral and written instructions and use a PC, with or without reasonable accommodation. This job also requires frequent exposure to confidential information.
 
Responsibilities:
 
● Research and assess business automation and functionality requirements.

● Develop functional specifications for communication to clients and technical staff.

● Interview stake holders, gather requirements and analyze the business problem.

● Ability to work with programmers and come up with data modeling, business process modeling and user inter face design.

● Ability to think creatively about solving business problems.

● Familiarity with various requirement methodologies: use case, UML diagrams, iterative methodologies, is a plus.

● Consult with technical staff on database and technical specifications.

● Develop and maintain project plan and reporting documents.

● Coordinate all phases of Software Development Life Cycle (SDLC).

● Develop queries and reports using DCS database tools.

● Present training for end-user applications and methodologies to customers.

● Act as a liaison between IS and customers.

● Manage product back log, conduct scrum meetings, and facilitate agile development.

● Prioritize product back log with sponsors.

● Work independently with little guidance.

● Take pro-active measures and plan activities in advance.

● Ability to manage and prioritize multiple projects with varying timelines independently and deliverables.

● Flexible and able to adapt as part of dynamic business environment.

● Strong verbal, writing, presentation and negotiation skills. 

Minimum Qualifications:

● Requires a Bachelor’s Degree and three years experience in related field(s). 

● Prefer Masters Degree and/or multidisciplinary education/experience in business systems and process engineering.

Physical demands and work environment:

The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

● Physical demands: While performing the duties of this job, the employee is occasionally required to walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; balance; stoop; talk or hear. The employee must occasionally lift and/or move up to 15 pounds. Specific vision abilities required by the job include close vision.

● Work environment: The work is limited to the office environment with occasional trips to other office facilities or locations necessitating walking outdoors or driving. The noise level in the work environment is usually minimal.

This description provides information regarding the essential functions of the designated job, and the general nature and level of work associated with the job. It should not be interpreted to describe all the duties whose performance may be required of such employees or be used to limit the nature and extent of assignments such an individual may be given.
 

Please submit cover letter, resume, references and salary requirements to: jobs@deltadentalva.com.
 

EOE. Drug-Free Work Environment.

Dental Auditor

Reviews claims with the submitted diagnostic material to make proper benefit determination based on the group contract and DeltaUSA and departmental established guidelines. Responsible for clearing queues and pending claims for additional information. Forwards claims to dental consultant for review based on established guidelines.

  • Reviews diagnostic material (i.e. X-rays, periodontal charting) to determine benefits.
  • Refers claims to dental consultant for review when diagnostic material does not appear to support the procedure requested.
  • Follows DeltaUSA guidelines and departmental guidelines for claims processing.
  • Refers claims to the fraud and abuse department for providers with suspicious patterns on claim submissions.
  • Reports to Clinical Professional Services Manager


5+ years of dental experience. The ability to read X-rays and prior dental assisting or dental hygiene experience required. Preference will be given for individuals with prior insurance background. 

An employee in this position performs work in an office setting. This employee must have the ability to read written materials, write, follow oral and written instructions, use a PC and perform other support duties, with or without reasonable accommodation. The job requires the ability to follow established procedures with moderate decision-making.

Please submit resumes to: jobs@deltadentalva.com.  


EOE. Drug-Free Work Environment.

 

Billing Representative

Job Summary:

  • Responds to inquiries and process requests received from External Customers.
  • Communicates to the External Customers all issues identified through the Enrollment and Billing process.  Reaches a mutual resolution to all open issues prior to the next billing cycle. 
  • Processes Client payments on a weekly, monthly, quarterly and annual basis.  Reconcile and balance payments to the billed Accounts Receivable on the automated systems.
  • Creates all necessary financial adjustments to the automated system to reflect accurate Accounts Receivable reporting.
  • Performs collection activities on past due amounts.
  • Produces monthly billing statements within specified timeframes.  Verify accuracy of billings and prepare bills for mailing.
  • Trains new billing representatives on the daily processing functions and updates as required.
  • Performs quality checks to ensure proper handling of accounts and good understanding of policies and procedures.
  • Works on Special Projects as assigned by Management.
  • Other duties as assigned to meet business needs. 

Job Accountabilities:

  • Provides timely and accurate resolution of inquiries within 48 hours of receipt.
  • Communicates actions taken professionally to the inquirer.
  • Prepares accurate, professional, and understandable letters, faxes and telephone communication to External Customers.
  • Applies payments to Accounts Receivable records in the automated systems.  Analyzes variances and reconcile accounts. Documents actions taken and communicates with the customer as needed.
  • Provides accurate and timely financial reporting of AR and general ledger balances.
  • Strives to collect past due amounts from External customers utilizing collection letters and making outbound calls. 
  • Prepares statements accurately and mails them on or before the scheduled date.
  • Follows documented procedures for the Billing & Eligibility Department.
  • Measurable quality tracking to meet KPI’s and corrective action plans to address any errors.
  • Works on special projects as required. 

Minimum Qualifications:

  • High School Diploma required. 
  • Some college (an associates Degree) is preferred with an emphasis on math and accounting courses or work experience in related field.
  • Previous experience in an office environment, preferably in the insurance industry is desired.

Physical demands and work environment:

The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Physical demands: While performing the duties of this job, the employee is occasionally required to walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; balance; stoop; talk or hear. The employee must occasionally lift and/or move up to 15 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
  • Work environment:  The work is limited to the office environment with occasional trips to other office facilities or locations necessitating walking outdoors or driving. The noise level in the work environment is usually minimal.

This description provides information regarding the essential functions of the designated job, and the general nature and level of work associated with the job. It should not be interpreted to describe all the duties whose performance may be required of such employees or be used to limit the nature and extent of assignments such an individual may be given.

To apply: please submit resume and salary requirements to: jobs@deltadentalva.com.

EOE. Drug-Free Work Environment.

 

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