Operations Coordinator

Job Type Full-timeDescriptionCome Smile with Us!Delta Dental of Iowa invites applicants for Operations Coordinator to support accurate, consistent eligibility and claims processing through quality assurance, training, and subject matter expertise. You will be a key resource for Operations teams by providing guidance on complex processing issues, handling escalated customer service calls and written inquiries, and supporting continuous improvement initiatives. You will participate in departmental and company projects, including system and process testing, and work collaboratively with internal and external stakeholders to consistently deliver Delta Dental's quality service standards. Here's an opportunity to demonstrate professionalism, accountability, and a customer-focused approach while working effectively in a highly collaborative, self-managed team environment.Learn why Jennifer enjoys working on the Operations team.Why Delta Dental of Iowa?For your smile. For your health. For your community.At Delta Dental of Iowa, we're more than just a dental and vision insurance company. Improving health and wellness is at the center of everything we do. As a not-for-profit, we aim to build stronger communities by investing in actions that promote and improve health. Delta Dental of Iowa invests 40% of our dollars directly back into the communities we serve.Come see why we are passionate about "Bringing Smiles" to our customers. Our team enjoys competitive pay and benefits, an awesome "One Team" approach, and a company culture that fosters "Exceptional Quality Service" and "Leadership at All Levels." Together, we can make a difference - not only in Iowa but across the country.Essential Functions and Principal AccountabilitiesPerform quality assurance reviews to ensure accuracy, compliance, and adherence to operational standards; provide feedback, complete reports, and communicate results to leadership and employees. Coordinate, conduct, and support training for claims, eligibility, and related operational processes; write, maintain, and update procedures and documentation. Serve as a subject matter expert for eligibility and claims processing, providing guidance and resolution for complex or escalated issues. Respond to escalated customer service and stakeholder inquiries via phone, written correspondence, or in person within established turnaround times and quality expectations. Act as the primary contact for EDI file management; partner with Technology, groups, brokers, and vendors to implement, maintain, troubleshoot, and resolve file issues. Respond to complaints and triage incident reports in support of the Compliance team; complete required reports and analyze data to identify trends, risks, and compliance concerns.Support operational functions including processing suspended claims, adjustments, vendor invoices, onboarding/offboarding tasks, and providing backup coverage as needed. Participate in departmental and company projects, system testing, meetings, and workflow improvement initiatives.Promote operational accuracy, efficiency, and continuous improvement by identifying trends, risks, and opportunities for improvement. Maintain effective working relationships with internal teams, external partners, vendors, and stakeholders to support high-quality service delivery. Communicate clearly and professionally regarding service-related issues and resolutions. Demonstrate professionalism, accountability, and sound judgment while representing Delta Dental internally and externally. Maintain strict confidentiality and compliance with HIPAA and all applicable policies. Perform other duties as assigned. RequirementsRequiredBachelor's degree or equivalent experience (minimum 3 years) in customer service, claims processing, or benefits administration. Working knowledge of insurance benefits administration, including eligibility and enrollment processes, claims processing, deductibles, maximums, coordination of benefits, and dental terminology. Strong written and verbal communication skills, with the ability to interact professionally and effectively with internal and external stakeholders. Demonstrated analytical and problem-solving skills, including the ability to analyze information, exercise sound judgment, and make independent decisions. Proficiency with computer applications and systems, including Microsoft Excel, Word, and operational or database systems. Demonstrated organizational skills, including the ability to prioritize, manage multiple tasks, and work independently and collaboratively in a fast-paced environment. Dependable attendance and punctuality.Preferred Experience working in quality assurance or training-focused role within claims or benefits administration. Strong orientation toward a metrics-driven, high-quality operational environment. Experience identifying trends, risks, or process improvement opportunities through QA or operational data. Familiarity with EDI processes, file management, or vendor/system integrations. Experience supporting or participating in operational projects, system testing, or process improvement initiatives.Delta Dental of Iowa is an Equal Opportunity Employer that does not discriminate on the basis of race, sex, national origin, religion, age, disability and any other characteristic protected by applicable law. It is also the policy of Delta Dental of Iowa to take affirmative action to employ and to advance in employment, all persons regardless of their status as individuals with disabilities or protected veterans, and to base all employment decisions only on valid job requirements.

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