Operations Coordinator

Description

Come Smile with Us!

Delta Dental of Iowa invites applicants for Operations Coordinator to support accurate, consistent eligibility and claims processing through quality assurance, training, and subject matter expertise. You will be a key resource for Operations teams by providing guidance on complex processing issues, handling escalated customer service calls and written inquiries, and supporting continuous improvement initiatives. You will participate in departmental and company projects, including system and process testing, and work collaboratively with internal and external stakeholders to consistently deliver Delta Dental’s quality service standards. Here's an opportunity to demonstrate professionalism, accountability, and a customer-focused approach while working effectively in a highly collaborative, self-managed team environment.

Learn why Jennifer enjoys working on the Operations team.

Why Delta Dental of Iowa?

For your smile. For your health. For your community.

At Delta Dental of Iowa, we’re more than just a dental and vision insurance company. Improving health and wellness is at the center of everything we do. As a not-for-profit, we aim to build stronger communities by investing in actions that promote and improve health. Delta Dental of Iowa invests 40% of our dollars directly back into the communities we serve.

Come see why we are passionate about "Bringing Smiles" to our customers. Our team enjoys competitive pay and benefits, an awesome "One Team" approach, and a company culture that fosters "Exceptional Quality Service" and "Leadership at All Levels." Together, we can make a difference – not only in Iowa but across the country.

 Essential Functions and Principal Accountabilities

• Perform  quality assurance reviews to ensure accuracy, compliance, and adherence to  operational standards; provide feedback, complete reports, and communicate  results to leadership and employees. 
• Coordinate,  conduct, and support training for claims, eligibility, and related operational  processes; write, maintain, and update procedures and documentation. 
• Serve  as a subject matter expert for eligibility and claims processing, providing  guidance and resolution for complex or escalated issues. 
• Respond  to escalated customer service and stakeholder inquiries via phone, written  correspondence, or in person within established turnaround times and quality  expectations. 
• Act  as the primary contact for EDI file management; partner with Technology,  groups, brokers, and vendors to implement, maintain, troubleshoot, and resolve  file issues. 
• Respond  to complaints and triage incident reports in support of the Compliance team;  complete required reports and analyze data to identify trends, risks, and  compliance concerns.
• Support  operational functions including processing suspended claims, adjustments,  vendor invoices, onboarding/offboarding tasks, and providing backup coverage  as needed. 
• Participate  in departmental and company projects, system testing, meetings, and workflow  improvement initiatives.
• Promote operational accuracy, efficiency, and continuous improvement by  identifying trends, risks, and opportunities for improvement. 
• Maintain effective working relationships with internal teams, external  partners, vendors, and stakeholders to support high-quality service delivery. 
• Communicate clearly and professionally regarding service-related issues  and resolutions. 
• Demonstrate professionalism, accountability, and sound judgment while  representing Delta Dental internally and externally. 
• Maintain strict confidentiality and compliance with HIPAA and all  applicable policies. 
• Perform other duties as assigned. 

Requirements

Required

1. Bachelor’s  degree or equivalent experience (minimum 3 years) in customer service, claims  processing, or benefits administration. 
2. Working  knowledge of insurance benefits administration, including eligibility and  enrollment processes, claims processing, deductibles, maximums, coordination  of benefits, and dental terminology. 
3. Strong  written and verbal communication skills, with the ability to interact  professionally and effectively with internal and external stakeholders. 
4. Demonstrated  analytical and problem-solving skills, including the ability to analyze  information, exercise sound judgment, and make independent decisions. 
5. Proficiency  with computer applications and systems, including Microsoft Excel, Word, and  operational or database systems. 
6. Demonstrated  organizational skills, including the ability to prioritize, manage multiple  tasks, and work independently and collaboratively in a fast-paced environment.  
7. Dependable  attendance and punctuality.

Preferred 

1. Experience  working in quality assurance or training-focused role within claims or  benefits administration. 
2. Strong  orientation toward a metrics-driven, high-quality operational environment. 
3. Experience  identifying trends, risks, or process improvement opportunities through QA or  operational data. 
4. Familiarity  with EDI processes, file management, or vendor/system integrations. 
5. Experience  supporting or participating in operational projects, system testing, or  process improvement initiatives.

Delta Dental of Iowa is an Equal Opportunity Employer that does not discriminate on the basis of race, sex, national origin, religion, age, disability and any other characteristic protected by applicable law. It is also the policy of Delta Dental of Iowa to take affirmative action to employ and to advance in employment, all persons regardless of their status as individuals with disabilities or protected veterans, and to base all employment decisions only on valid job requirements.