Dental Network Maintenance and Grievance Coordinator

• Acts as Grievance Coordinator for complaints and grievance resolutions.
• Assists in handling escalated member and/or provider concerns
• Maintain grievance database and provide quarterly reports to VP, Dental Science & Network Strategy.
• Provides utilization review, reports and investigations as needed.
• In-house and outsourced recruitment/retention support, including but not limited to policy explanation, servicing the dental community and dentist inquiries, identifying and responding to network leads for potential network growth.

• Coordinates daily calls to offices verifying the office’s information is accurately reflected in the DDIL provider directory and update as needed.

• Responsible for establishing and maintaining provider records in multiple provider databases. This complex process requires cross-checking existing databases and data entry.
• Responsible for processing dental network agreements within guidelines, reviewing all applications for thoroughness, and communicates with the offices that fail to complete the application in its entirety.
• Provide courteous, professional, and confidential service to dental professionals by telephone, electronic/written or in person regarding network information, rules and regulations, policy and procedures, provider issues, change requests and claim related inquiries.

• Knowledge of dental insurance products
• Knowledge of dental claims processing and dental claims system
• 3-4 years of experience in Provider Relations and/or related experience
• Extensive knowledge of dental terminology with an understanding of managed care
• Proficiency with Microsoft Office programs

111 Shuman Boulevard, Naperville, IL 60563 Hybrid work $24 - $28 an hour - Full-time, Pulled from the full job description

• Tuition reimbursement
• 401(k) matching
• Paid time off
• Dental insurance
• Disability insurance
• Volunteer time off
• On-site gym, * Free dental for employees and their dependents
• Competitive benefits: free vision, life, STD/LTD for employees/medical options for many budgets/401k and company match

• Generous PTO program; 11 paid holidays per calendar year

• Great people and culture
• Healthy work/life balance
• Conveniently located off I-88 in Naperville, IL
• Hiring base pay range is $24 - $28 per hour

Delta Dental of Illinois is an equal opportunity employer.

We are the largest dental insurance company and continue to grow. Based in Naperville, IL Delta Dental of Illinois has over 50 years of oral health experience and is dedicated to clients and employees alike.

Our company culture is inclusive, innovative and focused on achieving our goals. We believe in improving oral health through our dental benefit programs and through our Foundation, which develops and supports projects and organizations that improve access to oral healthcare and oral health education.

Delta Dental of Illinois is seeking a Dental Network Maintenance & Grievance Coordinator is responsible for coordinating, tracking, and resolving member grievances working with Members, Dentists/Dental Providers, and internal stakeholders. This position is also responsible for maintaining DDIL provider directory for accuracy and facilitate follow up with leads for new provider contracts.