Job Description

Location:

Candidates located more than 1 hour outside of our corporate office in Roanoke, VA and residing in the following states may be considered for remote work: FL, GA, ID, MD, NC, NE, SC, TN, VA, WI, WV

Position Summary:

The Group Implementation Specialist is responsible for reviewing documentation received from the Sales Representatives to identify how to input information into the claims and billing system to ensure proper processing. In addition, the Group Implementation Specialist prepares the legal group contracts and benefit plan booklets for both new and existing groups. The legal documents that the Group Implementation Specialist prepares are custom documents. In order to create these custom documents, the Group Implementation Specialist must possess extensive knowledge of Insurance Law and mastery skills of the suite of Microsoft Applications. The Group Implementation Specialist is required to work closely with Compliance for the filing of custom documentation for groups.

The Group Implementation Specialist is also responsible for inputting group benefits, reporting information, , rates, and broker information into the claims and billing system. In order to accurately input the group information, the Group Implementation Specialist must have an extensive knowledge of the following:

Product and plans information, Claims policies, procedures and Underwriting Guidelines, Billing and Eligibility procedures. ,. In addition, the Group Implementation Specialist will be required to provide additional information for groups as requested. The Group Implementation Specialist also provides support to the Sales staff on a daily basis. The Group Implementation Specialist will also be asked to perform other duties or special projects on an as needed basis.

Essential Functions:

• Work is performed in a team setting with multiple priorities and tasks, often working under time constraints.
• Must possess mastery skills of the suite of Microsoft Applications.
• Works closely with Sales Representative to ensure all documentation for new groups is received and information is validated to be correct before loading into claims and billing systems.
• Identifies and inputs benefits and group structure that must be loaded into claim and billing system.
• Frequent contact with group administrators, agents, ,consultants and internal departments during new group implementation and renewals, requiring excellent customer service skills.
• During group renewal process, the Group Implementation Specialist identifies any and all changes to group benefits or commission schedules and processes these changes to each account.
• Creates the legal documents between clients, including the contract and booklets for both new groups and amended groups.
• Creates customized contract documents and other customized documents as requested by internal and external customers.
• Assists in maintaining master documents for all contracts.
• Implements rate amendments, eligibility transfers, and any other necessary changes into the claims and billing system.
• Responsible for handling any communications materials (benefit summaries, contact updates, etc.) and updates any correspondences that are impacted by changes.
• Responsible for updating information in the claims and billing system that determines both internal and external commission payments.
• Creates 5500 Reports for external customers.
• Perform regularly scheduled audit process for external documents.
• Trains and assists team members as needed.

Qualifications/Education/Experience:

• Education and experience equivalent to a two-year college degree. Four-year degree preferred.
• Extensive knowledge of applications within Microsoft Suite.
• Ability to collaborate with other internal teams, including but not limited to Sales/Account Management, Underwriting, Configuration, Provider Relations, and Back End Operations.
• Must be comfortable working on multiple tasks and projects at once and be able to effectively prioritize workload.
• Demonstrated success working in a fast-paced environment with tight deadlines and the ability to shift focus from one project to another quickly is critical.
• Attention to detail is critical for success when reviewing group renewal information.
• Prior customer service experience, including within a dental office, health care sales or service center. License to sell insurance preferred.
• Must have excellent verbal and written communication skills with the ability to effectively communicate and interact with all levels of personnel and the general public.
• Must have demonstrated success in a customer service role, handling both outbound and inbound calls. Familiarity with using an enterprise phone messaging system (eg. Talk Desk) is a plus. Experience using an IT service desk application (JIRA, etc.) is preferred but not required
• Strong interpersonal and communication skills.

Compensation & Benefits:

Delta Dental of Virginia offers a comprehensive compensation package in addition to your annual base salary which include the following:

• Annual Incentive Plan available to all team members
• Comprehensive Insurance Coverage (including Medical, Dental, Vision, Pharmacy benefits, Life Insurance and AD&D)
• Voluntary Benefits (such as Critical Illness/Accident, Pet Insurance and Legal Resources)
• Employee Assistance and Health and Wellness programs (including an onsite gym!)
• 24/7 On-Demand TextCare: Text a board-certified medical provider, for you and your loved ones, 24/7 - and get a provider response in under 5 minutes.
• Generous Holiday/PTO offerings, with an extra paid day off during your birthday month
• 8hrs Volunteer Time Off
• Flexible Spending Accounts and Health Savings Accounts
• Comprehensive 401(k) plan with matching and Profit Sharing program
• Professional development opportunities
• Flexible hybrid/remote work schedule
• Tuition Reimbursement / Educational Assistance
• A great team!

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