Job Description
About Us
Delta Dental of New Jersey and Delta Dental of Connecticut are proud to be leaders in the dental insurance industry, offering a wide range of plans to meet the needs of individuals and employers alike. As New Jersey’s largest dental coverage provider, we are committed to delivering high-quality, cost-effective solutions designed to meet the diverse needs of our customers and our team is growing.
In Connecticut, Delta Dental of Connecticut, Inc. provides fully insured dental coverage, while Delta Dental of New Jersey administers self-funded dental benefit programs. We proudly serve over 1.7 million individuals through more than 1,800 groups, including commercial, school board, and government programs.
Since 1969, Delta Dental has been at the forefront of innovation, offering programs that control costs while ensuring the highest level of benefits.
As a member of the national Delta Dental Plans Association, we provide national dental coverage to over 75 million people across 139,000 groups. Our commitment to excellence is reflected in our prestigious Standard & Poor’s “A+” rating for financial strength. Join us and be a part of a trusted company with a rich history of delivering quality dental benefits to millions.
About the Job
To independently identify, investigate, analyze, and conduct investigations to determine whether health care FWA (fraud, waste, and abuse), overbilling and/or violations of contract or law has occurred, as well as compliance with Delta Dental’s Bylaws, Rules and Regulations, compliance with the Participation Agreement, and adherence to government regulations as required by Delta Dental’s Fraud Prevention and Detection Plan.
This is a full time hybrid position, in office Tuesdays and Wednesdays, and remote Mondays, Thursdays and Fridays. We offer excellent benefits including medical, dental, Rx and vision, 401k+, tuition reimbursement, additional ancillary benefits, and ample paid time off.
Essential Functions & Responsibilities
Essential Qualifications
DDNJ Competencies
Adaptability/Flexibility
Communication
Computer Skills
Decision Making/Judgment
Dependability
Initiative
Personal Organization
Problem Solving/Analysis
Productivity
Quality
Knowledge, Skills & Abilities
Technical and Functional
Required Physical Abilities
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Working Environment
Experience, Education, and Certifications Required
Required Educational Level and Experience Required
Certifications required/preferred
Approvals
Management retains the discretion to add or change job duties at any time.
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