Why Delta Dental Plan of Michigan
FY2024 · Form 990Its mission and biggest programs, as filedProvides prepaid dental benefits, funds oral health research and education, and supports community outreach to ensure access to quality dental care for millions of members.
- Promoting Dental Care Delta Dental Plan of Michigan, Inc. is a leading prepaid dental benefits provider in the Midwest. The purpose of the organization is to advance and promote the improvement of oral health. This is done by offering innovative…$1.10B spent in FY2024
Before you apply
FY2024 · Form 990Independent: from IRS data, not the orgAbout the role
The org's own posting, as writtenJob Title: Senior Encounter Data Specialist Number of Positions: 1 Location: Okemos, MI Location Specifics: Hybrid Position Job Summary: At Delta Dental of Michigan, Ohio, and Indiana we work to improve oral health through benefit plans, advocacy and community support, and we amplify this mission by investing in initiatives that build healthy, smart, vibrant communities. We are one of the largest dental plan administrators in the country, and are part of the Delta Dental Plans Association, which operates two of the largest dental networks in the nation. At Delta Dental, we celebrate our All In culture.
It’s a mindset, feeling and attitude we wrap around all that we do – from taking charge of our careers, to helping colleagues and lending a hand in the community. Position Description: Leads the organization, analysis, correction and recommendation of solutions to internal and external stakeholders regarding encounter data issues, policies, processes, requirements, and records. Primary Job Responsibilities: Represents the encounter team to leadership by presenting reports, project progress, metrics, deliverables, and other encounter-related updates.
Leads and oversees the correction of rejected encounters by researching, reviewing, and interpreting encounter data, identifying potential issues, and ensuring corrections comply with internal and external processing guidelines and best practices. Monitors, manages, and audits encounter submissions to ensure timely, accurate file submission and processing. Leads encounter implementation activities for new customer onboarding, driving cross-functional coordination and ensuring deliverables align with internal standards, regulatory expectations, and external customer requirements.
Serves as a key subject matter expert during internal and external audits by coordinating requested materials, completing audit responses, preparing supporting documentation, presenting findings, and monitoring audit-related reports to demonstrate compliance with audit requirements. Provides oversight of electronic data interchange (EDI) and X12 data exchange compliance, ensuring encounter transactions adhere to applicable industry regulations, HIPAA requirements, and partner-specific mandates.
Monitors the development, implementation, maintenance, and application of encounter policies, procedures, error libraries, and reporting tools to correct rejected encounters and support daily and weekly operational oversight. Monitors and evaluates related processes to ensure internal and external requirements are met, represents the encounter team when partnering with functional areas to maintain claims system support tables, and coordinates data entry or general data maintenance for eligibility, providers, fee sets, benefits and related records.
Oversees root cause analysis for encounter errors and reviews results, processes, and/or system programming with other departments to minimize repeat issues, identify opportunities for…
About Delta Dental Plan of Michigan
From its Form 990- Budget $1.25B · Health Care
- Staff 1,197 · founded 1957
- Pays its leaders $518K–$9.5M (12 reported)
- Open jobs 30 · Jobs at Delta Dental Plan of Michigan · Full 990 report