Associate, Dental Claims and Services Details

Associate, Dental Claims and Services

MVP Health Care - Schenectady, NY

Employment Type : Full-Time

Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds—tech people, numbers people, even people people—working together to make health insurance better. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference—it’s time to make a healthy career move to MVP!

Full-Time, Non-Exempt

This position will be responsible for accurately and efficiently adjudicating, reviewing and adjusting dental claims with the aid of Facets and Macess systems. Is responsible for optimum customer service on inbound calls from members and dental providers. Provides exceptional customer care to internal and external customers while consistently adhering to all call handling objectives, i.e. hold time, talk time, after call work and quality assurance. Responds promptly, accurately and effectively to all calls in a polite and professional manner. Ensures accurate and timely processing of dental claims in accordance with ancillary guidelines and benefits. Completes daily work as needed with flexibility to move from one process to another on a daily/weekly basis. Evaluates all business processes to proactively identify efficiency opportunities and partners with team leads to implement production and quality standards, identify trends and recognize process improvements with a focus on continuous improvement. Communicates directly with members and providers. Meets all departmental quality and financial goals. Keeps updated on job manual/process changes. Supports a culture of continuous learning, support, and inclusion. Performs other related duties as assigned.

POSITION QUALIFICATIONS

Minimum Education

High School Diploma required. Associates in Health, Business of related field preferred. Relevant work experience may be substituted.

Minimum Experience

Customer service experience required, experience taking inbound calls strongly preferred. Knowledge of CDT, HCPCS, ICD-10-CM coding systems and medical terminology preferred. Experience with Facets and Macess strongly preferred

Required Skills

Adaptability

Composure

Business Analysis

Strong Verbal and Written Communications

Critical Thinking and Problem Solving

Strong Time Management

About MVP
MVP Health Care is a nationally recognized, not-for-profit health insurer caring for more than 700,000 members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse, employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve. MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the EEO is the Law Poster and Supplement protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com

Please apply and learn more – including how you may become a proud member of our team.