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Northeast Delta Dental · 1 week ago

Electronic Data Interchange (EDI) Coordinator

Concord,NH,US

Full-time

Hybrid

Entry, Mid Level

$24/hr - $25/hr

2+ years exp

Northeast Delta Dental is a nonprofit member of Delta Dental Plans Association, recognized for its trusted dental insurance services across the region. They are seeking an experienced Electronic Data Interchange (EDI) Coordinator to facilitate accurate electronic enrollments and provide exceptional customer service to employer groups and Third-Party Administrators.

Health CareInsurance

No H1B

Responsibilities

Promotes accurate electronic file feeds by educating and training employer groups and TPAs about file formatting and requirements

Implements electronic group enrollments by receiving and entering eligibility records into the custom enterprise system. Updates current records as needed

Reviews enrollment data for accuracy by comparing and analyzing error reports and performing audits. Collaborates with TPAs and employer groups to reconcile discrepancies and update records

Improves claims adjudication by performing scenario testing, researching errors, and updating enrollment data in the custom enterprise system

Provides excellent customer service to employer groups by processing electronic eligibility files accurately and in a timely fashion; answering calls, and responding to email inquiries

Provides training, guidance, and information on electronic enrollment by maintaining and enhancing knowledge about the process and rules around setting up and receiving 834 transactions, electronic enrollment files, the subscriber benefit administration tool, and eligibility modules in the custom enterprise system

Maintains accurate process and procedure reference guides by documenting, reviewing, and updating department manuals, training materials, and related documentation