Operations Analyst — Claims & Client Setup

Delta-Denta; Providence (RI); On-site; USD 60,000 - 75,000; Full time

Job summary

Delta-Denta in Providence, RI is seeking an Operations Analyst to join the Operational team. This full-time role supports client setup, system configuration, claims resolution, and quality control of client transactions; you will respond to inquiries across departments and help ensure accurate processing.

The ideal candidate will handle client data changes, renewals, and rule configurations, while contributing to process improvements and cross-functional collaboration within a 40-hour workweek.

Qualifications

• High School Diploma or equivalent; Associates or Bachelor’s degree preferred.
• Excellent communication and organizational skills.
• Attention to detail and accuracy.
• Prior knowledge of database programs preferred.

Responsibilities

• Record system transactions to account for changes in a client’s general and/or benefit information.
• Quality control checks of all system transactions.
• Maintain and process client renewal transactions.
• Research and configure system rules based off client benefit modifications, CDT updates and companywide policy changes.
• Assist in oversight of the processing and adjudication of claims by guiding the activities of the claims analysts; monitors and communicates corporate policies and procedures to assure a high level of accuracy and completeness within established production and inventory standards.
• Interact regularly with Customer Service to answer claim-related questions.
• Becomes knowledgeable with analytical tools and collaborates/recommends new operational reports to Data Analytics team.
• Responsible for the quality of various operations department tasks including rule updates, coordination of benefit processing, ortho claims, internally entered claims pretreatments and client data management.
• Assists in the evaluation of all system releases to ensure accuracy and completion.
• Participates in pre-release testing with Project Management
• Participates in special projects as required by management.
• Performs other duties as assigned.

Skills

Excellent communication

Organizational skills

Attention to detail

Database concepts

Education

High School Diploma or equivalent

Associates or Bachelor's degree preferred

Job description

Delta-Denta in Providence, RI is seeking an Operations Analyst to join the Operational team. This full-time role supports client setup, system configuration, claims resolution, and quality control of client transactions; you will respond to inquiries across departments and help ensure accurate processing.

The ideal candidate will handle client data changes, renewals, and rule configurations, while contributing to process improvements and cross-functional collaboration within a 40-hour workweek.