Professional Relations Coordinator

Join Delta Dental of Wisconsin

Delta Dental of Wisconsin is seeking a Professional Relations Coordinator to assist our Professional Relations Team. This position is responsible for tasks including provider record maintenance, credentialing, preparing reports, selected review claim processing and supporting the Professional Relations teams, including workflow management and arranging logistics for department events.

This is an excellent opportunity to expand your skills and gain cross-functional experience.  We offer a collaborative work environment, comprehensive benefits, and ongoing professional development opportunities.

Why Join Us?

Delta Dental of Wisconsin offers a competitive and comprehensive benefits package, including:

• Medical and dental insurance
• 401(k) retirement plan with employer match
• Generous Paid Time Off (PTO) program
• Professional development and cross-training opportunities
• Career growth and advancement potential

Key Responsibilities

• Provide timely and accurate support through the Professional Relations phone queue and Professional Relations Coordinator inbox by addressing inquiries from dental offices related to provider agreements, fees, and claim reviews.
• Develop and maintain provider records
• Execute credentialing processes for all providers to ensure compliance with DDPA, NCQA, and CMS requirements, which includes accessing the National Provider Database
• Perform functions as NPF Administrator and/or NPF Alternate
• Assist with the completion of vital DDPA NPF tasks such as:
  • Error reports remediation
  • Annual Directory Accuracy Audit
• Perform processes related to 1099 records
• Administer review claims according to provider claim and code holds
• Maintain claims identified on 900 and OT report; contact dental offices for follow-up as
• Prepare filed fee updates for data entry
• Create and maintain process and procedure documents.
• Coordinate assigned support activities for meetings, conferences and department activities

Qualifications

Required Skills & Experience

• Associate degree in a related business field and two years’ experience in a business setting or equivalent combination
• Experience within the Insurance industry, or knowledge of dental business is preferred
• Participate in ME verification processes to ensure secure and authenticated access to the National Provider Database
• Demonstrated proficiency with MS Office Suite applications
• Ability to effectively and efficiently prioritize and execute multiple tasks
• Experience working in a fast-paced, team-oriented, collaborative environment
• Strong interpersonal, written and oral communication skills
• Strong customer service orientation
• Ability to make decisions and use good judgment when working independently
• Ability to operate a computer keyboard, mouse and other office equipment

What Makes You Successful

You are detail-oriented, take ownership of your work, communicate effectively, and continuously seek opportunities to improve processes and outcomes.

Ready to build your career with Delta Dental of Wisconsin? Apply today and become part of a team committed to improving oral health and delivering exceptional service to our members and partners.