About This Role
This role involves interacting with customers to address inquiries, concerns, and requests regarding products and services across various business lines. The Customer Service Representative will project a professional company image, deliver superior customer service, and ensure accurate information is communicated through multiple customer contact channels.
Responsibilities
- Assist providers by resolving coordination of benefits inquiries, including enrollment, third-party liability, and claims attachments
- Interpret and communicate accurate insurance coverage by understanding all processes and systems
- Document all customer interactions thoroughly and completely
- Educate customers and dental professionals on eligibility, benefits, claims payment, and authorizations
- Provide direction on using and understanding self-service tools
- Assist members in locating network dentists or assigning primary care dentists
- Appropriately route inquiries beyond scope to the correct department
- Research and resolve claim payment inquiries and ensure timely follow-up and resolution
- Maintain compliance with client policies and service standards
- Suggest process improvements and contribute to team success
Requirements
- High School Diploma or equivalent
- 2 years in a high-volume call center environment
- 1 year in the health insurance industry
- Proficient in Microsoft Office and multiple software systems simultaneously
- Ability to troubleshoot and set up computer equipment with minimal assistance
- Strong written and verbal communication
- High attention to detail, organizational ability, and teamwork
- Adaptable to a fast-paced production environment
- Excellent critical thinking and problem-solving skills
Nice to have:
- Medical/Dental terminology familiarity
- Medicare/Medicaid and claims/billing experience
- Experience with Cisco phone systems
- Bi-linguistic (Mandarin or Spanish)
Important Details
- Contract: 3-month contract + rolling extensions; long-term project
- Schedule: Monday–Friday, 6:00 AM – 7:00 PM CST (8-hour shifts within this window)
- Training and Onboarding Timeline: Classroom training (8:30 AM – 5:00 PM CT)
About the Company
This company operates in the insurance industry.
