We are currently hiring for a Billing & Enrollment Exchange Specialist. This role is responsible for the accurate and timely processing of electronic enrollment files, submission of the inbound enrollment reconciliation file, answer escalated inquiries from Federal and State Based Exchanges. Conduct analysis of Electronic Data Interchange (EDI) enrollment transactions and is responsible for resolving issues with exchanges.
Join Delta Dental of Wisconsin and grow your skills for promotional opportunities, while cross-training into other areas for a broad foundation of knowledge. Our positions are full time, 40 hours per week and benefit eligible. Delta Dental of Wisconsin offers a comprehensive benefit package which includes health and dental insurance, employer match within our 401(k) retirement plan, and a generous Paid Time Off program. You do not want to miss this opportunity, apply today.
In this role, our Billing & Enrollment Exchange Specialist will:
- Process enrollment files received via an electronic enrollment data feed and perform maintenance to accounts
- Perform data reconciliation to ensure accuracy and consistency of information exchanged through EDI based on state and federal reconciliation guidelines
- Monitor and respond to inquiries from the Federal or State Exchange through the appropriate escalation paths
- Create and maintain comprehensive documentation related to processes and changes
- Establish, document, and maintain EDI procedures in a shared directory and keep department up to date on EDI best practices
- Participate in Federal and State Exchange meetings and bring forth any required changes
- Acts as a Subject Matter Expert (SME) and escalation specialist related to problems or situations within EDI
- Responsible for accurate application of advanced premium tax credits and/or individual consumer premium payments
- Reconcile advanced premium tax credit and ensure policies are billed appropriate premium rates
- Perform user acceptance testing for enhancements or new processes related to federal or state exchange business
- Work collectively with internal and external partners to ensure proper file submission, error resolution and improve data collection and management
- Identify, communicate, and escalate critical issues to appropriate internal and external parties
- Collaborate with Client Experience and Product Services team to relay any changes that are required of the Client as a result of a Federal or State Exchange change
- Participate in team meetings and training sessions
- Attend and participate in meetings and/or projects as assigned by Leadership
- Learn and maintain knowledge of Wyssta policy processing agreements for all clients
- Respond promptly and professionally to inquiries from internal and external consumers relating to enrollment and billing issues; customer service may be provided by telephone, web, email or other type of communication
Education/Experience/Personal Requirements
- Associate degree in business or related field preferred
- 1 – 2 years related EDI experience preferred
- Computer skills, with demonstrated proficiency in MS Office Suite applications with intermediate Excel skills required
- Strong interpersonal, written and oral communication skills with the ability to communicate effectively with non-technical staff
- Self-motivated and directed
- Ability to effectively prioritize and execute tasks
- Analytical and problem-solving abilities
- Must be well-organized and attentive to detail
- Strong customer service orientation
- Experience working both in a team-oriented, collaborative environment and independently
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