The Command Center Reporting Specialist is responsible for designing, testing, and maintaining custom contact center reports to ensure data accuracy and operational efficiency. They will analyze performance trends, troubleshoot reporting issues, and collaborate with cross-functional teams to identify coaching and process improvement opportunities.
The specialist researches, analyzes, and resolves complex dental benefit cases, including compliance issues, appeals, and grievances for government programs. They also coordinate with legal and compliance teams to ensure timely resolution and accurate documentation of claims.
The specialist analyzes and adjudicates dental claims to identify potential fraud or aberrant treatment patterns. They also provide dental expertise and interpretations of policies to internal and external stakeholders.
The representative is responsible for recruiting and retaining dentists for Medicaid programs and managing relationships within the dental community. They will conduct presentations, resolve claims processing issues, and document all interactions in Salesforce.
The investigator is responsible for researching and reporting on questionable conduct by providers and members regarding claims, treatment patterns, and contract compliance. They will conduct audits, interview relevant parties, preserve evidence, and assist law enforcement or legal counsel in fraud detection and prosecution.
The specialist analyzes and adjudicates complex dental claims to ensure accurate benefits administration and compliance with policies. They also investigate provider reconsideration requests and coordinate with dental consultants to resolve questionable treatment cases.
The Professional Services Representative is responsible for recruiting and retaining dentists within the Delta Dental network while logging all interactions in Salesforce. They also conduct presentations, resolve claims processing issues, and represent the company at various dental meetings and community functions.
