Senior Encounter Data & Compliance Lead

Delta-Dental; Okemos (MI); Hybrid; USD 90,000 - 120,000; Full time

Job summary

Delta Dental of Michigan, Ohio, and Indiana is seeking a Senior Encounter Data Specialist in Okemos, MI. The role leads analysis, correction, and recommendations on encounter data issues, driving cross‑functional collaboration and ensuring compliance with HIPAA and payer requirements.

You will oversee EDI/X12 data exchange, audits, onboarding of new customers, and data maintenance for eligibility, providers, and benefits, while mentoring staff and coordinating with leadership on strategic

Qualifications

• Bachelor's degree in business administration or related field.
• Seven years of experience identifying, analyzing, or resolving business, system, or process issues.
• Experience with encounter data processing; Medicare/Medicaid regulatory familiarity preferred.
• Strong communication and analytical skills; ability to lead cross-functional work.
• Experience with data formats, databases and Microsoft Office.

Responsibilities

• Represents the encounter team to leadership with reports and updates.
• Leads correction of rejected encounters by researching data and ensuring compliance.
• Monitors and audits encounter submissions for timely processing.
• Oversees onboarding for new customers with cross‑functional coordination.
• Supports audits by coordinating materials and presenting findings.
• Oversees EDI and X12 data exchange compliance with HIPAA rules.
• Maintains encounter policies, error libraries and reporting tools.
• Maintains data for eligibility, providers, and benefits.
• Leads recruitment of new encounter data staff.

Skills

Analytical skills

Cross-functional leadership

Verbal & written communication

Problem solving

Multitasking

Interpersonal skills

Education

Bachelor's degree in business administration or related field

Tools

EDI formats

Database applications

Microsoft Office

Analytical reporting tools

Job description

Delta Dental of Michigan, Ohio, and Indiana is seeking a Senior Encounter Data Specialist in Okemos, MI. The role leads analysis, correction, and recommendations on encounter data issues, driving cross‑functional collaboration and ensuring compliance with HIPAA and payer requirements.

You will oversee EDI/X12 data exchange, audits, onboarding of new customers, and data maintenance for eligibility, providers, and benefits, while mentoring staff and coordinating with leadership on strategic