JOB DESCRIPTION

The Claims Processing Manager is responsible for providing leadership, oversight, support, and guidance to the Claims Processing team. Responsibilities include managing operations of the Claims Processing function to ensure that the quality and quantity of processing efforts meet or exceed the established service goals. This position will also lead staff management activities such as recruiting, interviewing, job performance evaluation, and providing input to departmental planning for workforce planning and staff training.

RESPONSIBILITIES

• Manages organizational Claims Processing workforce including determining staffing needs, setting goals, interviewing, coaching, and evaluating the performance of all direct reports.
• Responsible for providing leadership and development of Claims Processing Supervisors and Claims Processing Coordinators.
• Evaluates production and project requests to determine feasibility (cost/benefits analyses) and appropriate department resources.
• Ensures work and projects are completed within established schedules and budgets and takes corrective actions, as needed.
• Responsible for developing, monitoring, managing, forecasting, and maintaining controllable budget accounts.
• Ensures ongoing claims processing costs are as competitive as possible, within the limits of contractual requirements. This includes identifying new technologies and enhancements to existing services and improvement of procedures.
• Ensures proper implementation of the claims processing regulatory and compliance requirements. Balances the requirements of multiple major commercial and government clients including performance guarantees and processing turnaround time requirements.
• Serves as the point of contact for claims processing with sales and account services.
• Provides oversight and support in responding to group and regulatory audit requests to include implementation and monitoring of corrective action plans.

QUALIFICATIONS

• Bachelor's degree; 1+ years supervisory/management
• Minimum of 6 years of experience in the insurance industry with concentration in high volume claims processing required.
• Strong organizational and time management skills with the ability to multi-task while maintaining accuracy.
• Detail-oriented; flexible and creative.
• Interpersonal and communication skills to work effectively with all levels of staff.
• Working knowledge of claims processing flow and adjudication.
• Ability to interpret, develop and ensure adherence to enterprise and departmental policies and procedures.
• Strong leadership skills.

Base Pay Information

The national base pay range is a good-faith estimate of what Delta Dental may pay for new hires. Actual pay may vary based on Delta Dental's assessment of the candidate's knowledge, skills, abilities (KSAs), related experience, education, certifications and ability to meet required minimum job qualifications. Other factors impacting pay include prevailing wages in the work location and internal equity. $70,000 - $146,600

ADDITIONAL INFORMATION

Rewards to make you smile! We don't just want to make our customers happy - we want to give our employees a reason to smile, too. Delta Dental's comprehensive benefits package includes:

• Generous paid time off plus 12 holidays and your birthday off!
• Low-cost premium medical insurance options
• 100% paid dental and vision insurance
• Generous 401(k) matching and flat contribution
• Social responsibility and volunteer opportunities, including 16 paid volunteer hours annually
• Employee LiveWell program, focusing on overall employee well-being
• Fertility and diabetes benefits
• Employee discount program: AT&T/Verizon, entertainment, travel, and more!
• Culture of learning: career development and tuition reimbursement
• Career growth: we love promoting from within

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

Please note, Delta Dental will not sponsor applicants for work visas for this position.

#LI-Onsite

ABOUT THE TEAM

At Delta Dental, our success is only as strong as the people who execute it! We take enormous pride in being the nation's most recognized and widely-used provider of dental insurance - and we've come this far by living our core values of innovation, excellence, service and trust. Our vision is to motivate and empower every employee so that we're all inspired to take exceptional care of our customers, providers and ourselves. We believe in integrity, accountability, collaboration, and giving every employee equitable opportunity for their voice to be heard and development to be fostered.

If you're excited about the prospect of transforming the future of health care and growing in your career, join our smile revolution!

To see some of the smiling faces behind Delta Dental and to learn more about what our values and culture look like in action, connect with us on social media: Delta Dental Ins. on Facebook and Instagram, #LifeatDDins on Facebook and Instagram, Delta Dental Ins. on Twitter and Delta Dental Ins. on LinkedIn.

We are part of the Delta Dental Plans Association, a network of companies that provides dental coverage to 74 million people in the U.S. Delta Dental of California, Delta Dental of New York, Inc., Delta Dental of Pennsylvania and Delta Dental Insurance Company, together with our affiliate companies, form one of the nation's largest dental benefits delivery systems, covering 33 million enrollees. All of our companies are members, or affiliates of members, of the Delta Dental Plans Association, a network of 39 Delta Dental companies throughout the country.

Delta Dental is an equal opportunity employer. We are committed to building and maintaining a diverse and inclusive workplace for all employees. Applicants will not be discriminated against because of race, color, religion, creed, national origin, ancestry, citizenship status, sex (including pregnancy), sexual orientation, gender or identity expression, age, disability, marital status, medical status, veteran status or any other status protected under federal, state, or local law. In addition to federal law requirements, Delta Dental complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Unfortunately, our Delta Dental Enterprise is unable to hire individuals residing in Alaska, North Dakota, Nebraska, Hawaii, Oklahoma, Vermont, Maine, West Virginia, New Hampshire, Wyoming, Puerto Rico or other US Territories at this time.

Proof of eligibility to work in the United States must be provided if selected for hire.

Delta Dental* has enacted a COVID-19 vaccination policy to protect all employees and the communities we serve due to the ongoing impacts of the COVID-19 pandemic. Accordingly, we require all employees to be fully vaccinated for COVID-19. Are you able to comply with our policy of being fully vaccinated by your start date if an offer is made or have a medical or sincerely held religious exemption for receiving a COVID-19 vaccine? Failure to comply with our policy and submit proof of compliance or receive approval for a valid medical or sincerely held religious belief exemption prior to your start date will nullify any offer of employment extended to you.

• Delta Dental includes: Delta Dental of California, Delta Dental Insurance Company, Delta Dental of Pennsylvania, and Delta Dental of New York