Claims Data Specialist
DentaQuest - Grafton, WI

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Oversee the ongoing and ad-hoc reporting needs of DentaQuest’s internal and external customers. Revise and/or develop reporting procedures, polices and standards and communicate to customers. Initiate and manage the reporting application & self service reporting tool. Analyze all internal and external reports.

  • Assist in developing reporting standards and protocols within the Claims Payment Department
  • Run production reports in accordance to company and department standards
  • Perform ongoing analysis of trends and outcomes
  • Research and test appropriate tools for reporting production and department data and statistics
  • Develop and maintain mechanisms to track and organize reporting processes and tasks
  • Run hourly and daily queue reports to ensure claims do not exceed turn around times
  • Contact cross functional department queue managers and coordinate reporting requirements to meet corporate standards
  • Develop and maintain quality reports to departmental and senior management regarding reporting functions
  • Prepare ad hoc data reports and analysis summaries as requested
  • Prepare both internal and external daily, monthly, and quarterly reports
  • Organized and maintain a library of reporting definitions, stored procedures, and templates that that include naming conventions and documentation
  • Manage the process to identify, revise, and convert existing reports to new database and reporting tool platforms
  • Perform technical business analysis of report outcomes
  • Consult with cross-departmental staff in defining claims payment reporting needs
  • Routinely audit reporting processes for constancy with establish guidelines and acceptable outcomes
  • Train departmental users on reporting software tools
  • Adhere to DentaQuest business processes
  • Other duties as assigned
Required Experience
  • Bachelor’s Degree in Business or Computer Science, or related experience required
  • 4+ years of related experience in dental or healthcare field required.
  • 2+ years report building experience required.
  • Knowledge of SQL Reporting Services and MS Access required
  • Knowledge of UM terminology required
  • Must have the ability to write SQL reports in self serve database
  • The following skills and abilities required:
  • Excellent analytical skills
  • Excellent interpersonal skills.
  • Excellent verbal communication skills.
  • Ability to prioritize and organize multiple tasks.
  • Ability to remain organized with multiple interruptions.

About this company
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