Job Description

Job Description

Job Description

Delta Dental of New Jersey, located in Parsippany NJ is currently seeking a TEMPORARY Professional Relations Representative. In this role, you'll follow guidelines and resolve issues from dentists, members and other Delta Dental Member Companies as well as handle general provider servicing, communications, projects and file maintenance relating to participation, credentialing, and directory listings, fee filing, pricing, general policies and procedures and other Professional Relations functions.

This is a hybrid position , in office Tuesday and Wednesday, and remote Monday, Thursday and Friday, and the hours are 8 am to 4:30 pm.

Essential Functions & Responsibilities

• Handles incoming calls and correspondence regarding filed fees, pricing, participation and other provider concerns, coordinating adjustment request to customer service.
• Researches and resolves inquiries and responds to customers with an appropriate and accurate written or verbal notification.
• Performs all tasks necessary to resolve all questions based on the Participating Dentist Handbook
• Handles and coordinates new par workflows with Credentialing Unit and Network Development.
• Responsible for correspondence on various inquiries by entering data in PC.
• Researches and responds to balance billing and other subscriber inquiries requiring dispute resolution, by utilizing spreadsheet and word processing software.
• Analyzes inquiries regarding IRS Form 1099. Corrects and responds as necessary as indicated by management.
• Assists management with assigned projects including directory development.
• Contact person for the Network Coordinators, Claim Verification and Customer Service when internal research is required.
• Logs incoming fee filing, etc. utilizing spreadsheets, data base and word processing software.
• Assists with correspondence and incoming calls and Delta USA concerns via local and national systems (NPF).

Essential Qualifications

Competencies

Adaptability/Flexibility

Communication

Computer Skills

Customer Focus

Dependability

Job Knowledge

Productivity

Quality

Teamwork

Knowledge, Skills & Abilities

Technical and Functional

• Proficient with Microsoft Word and Excel and Internet Explorer/Chrome
• Basic knowledge of dental benefit products and plan design
• Excellent verbal and written communication skills
• Strong math aptitude
• Must possess a positive attitude and the ability to work cooperatively in a team environment
• Must regard excellence in customer service as a priority
• Excellent problem solving skills

Required Physical Abilities

The physical demands 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.

• Ability to sit and perform extensive close keyboard and PC work including data entry
• Ability to walk, talk or hear
• Occasionally required to stand and reach with hands and arms

Working Environment

• Ability to meet deadlines and attendance standards.
• The noise level in the work environment is usually moderate.
• This classification will be required to sign a confidentiality agreement.

Experience, Education and Certifications Required

Experience Required

• Minimum of 1-3 years customer service/provider relations experience, dental industry preferred

Required Educational Level

• Requires high school diploma or equivalent.

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