Digital Service Rep II at DentaQuest in Milwaukee, Wisconsin

Job Description:

The Digital Services Representative II is responsible for coordinating the receipt and digitization of all paper documents including, but not limited to, claims, authorizations, Fraud and Complaints/Grievances/Appeal mail as well as Credentialing. Documents are scanned based on prescribed procedures to direct appropriately for processing.

This includes the digitization of x-rays and ortho models ensuring all contractual guidelines and compliance regulations are met. This position is responsible for ensuring DentaQuest meets all quality control guidelines and turnaround times set by state and federal regulations and/or plan contracts specific to Intake.

NOTE: This role reports to the Milwaukee office. It is not a remote role.

Primary Job Responsibilities

• Accountable for robust understanding of Delta, Commercial, Vision as well as State & Health Plan business clients, client requirements, claim & UM policies, and procedures that relate to Intake


• Recognition of variety of options for scanning selections -- Non-Standard, OCR On-shore, OCR Off-shore, Business Docs, etc.


• Quality check of all prepared document packs to ensure accuracy before scanning


• Ability to prioritize and delegate scan responsibilities to other team members when Scan Lead, ensuring all tasks related to scanning are completed within proscribed SLAs


• Timely and accurate scan/load of all Trailing documents for attachment to existing claims in Windward which requires keying of the appropriate DCN for matching purposes


• Perform daily x-ray & ortho model reconciliation to ensure all x-rays/ortho models were digitized correctly and matched with their corresponding claim in the system. Research and resolve any discrepancies as appropriate


• Accurately log all CG&A scan information on Business Document Scan log to ensure balance of daily Business Document Reconciliation


• Efficiently and accurately operate Fujitsu hardware with Kofax scanning software to digitize all documents


• Weekly maintenance and cleaning of scanning equipment to ensure hardware working at maximum potential


• Document and escalate system problems by opening ServiceNow tickets and notifying appropriate departments


• Accurately log all scan information on Daily Scan Log to ensure daily reconciliation of volume scanned against volume released to OCR vendor


• Digitizing of Ortho models using ShapeGrabber software


• Digitizing of X-Rays using P&R software


• Assist management with development of staff training program and process documentation to support cross-training initiatives within the department


• Communicate process improvement ideas to boost departmental efficiency


• Assist with testing to support system updates and new business


• Participate in peer to peer training as requested to assist new team members and/or increase personal knowledge of functions


• Adhere to business processes


• Perform duties of Digital Services Rep I as necessary


• Performs other duties as assigned

Required:

• 2+ years of office work experience

• 1+ years of mailroom experience

• High School Diploma or equivalent


• Strong attention to detail and high degree of accuracy


• Excellent interpersonal skills


• Acceptable written and oral communication skills


• Knowledge of general computer software


• Ability to prioritize and organize multiple tasks


• Ability to work in excess of 40 hours in a week when necessary, as needed or required to meet business needs


• Interacts in a cooperative, professional, and effective manner with all internal and external personnel

11100 West Liberty Drive, Milwaukee, Wisconsin 53215 Apply Now