Customer Service Representative-Dental Experience Required


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Position Description

Position Description
Responds to questions from prospective and existing members, groups, partners and dental offices regarding products and plans. Requires resolution of problems with claims/transactions, complaints and appeals with dentists, and group enrollment. Provides online and email support by responding to service, technical and financial question. Troubleshoots and provides resolution by delivering consultative support to questions. Works with a wide variety of internal resources to resolve issues to ensure customer satisfaction.

Essential Functions:
• Responds to current and prospective customer questions and complaints/appeals in a timely and empathetic manner via telephone or web inquiries
• Researches complaints, appeals, claims, processing issues, benefit and eligibility requests and all communication with external and internal customers
• Collaborates with Operations to review claims and decisions regarding payment
• Answers inquiries from dental offices to clarify coverage levels, identify allowable procedures, and resolve claims payment issues
• Builds a strong rapport with dental office staff, groups and members to ensure a positive perception of the company within the community
• Support outbound phone or messaging campaigns that support consumer and provider engagement
• Other duties as assigned

Qualifications: (Education/Experience/Skills Required)
• High school diploma or equivalent, college degree preferred
• Previous customer contact experience (i.e. customer call center, dental office experience, or experience within a similar insurance system)
• Dental office, clinical assistant or insurance necessary
• Excellent communication skills (verbal and written)
• Attention to detail and accuracy essential

Type: Full-time