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***Candidates must reside in the Eastern or Central US Time Zones. No other Time Zones or countries will be considered***
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Title:
Dental Customer Service Representative
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FLSA Status:
Non exempt
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Shift: 7.5 hours/day, 37.5 hours/week
Flex hours between 8:00 am to 6:00 pm
Monday through Friday, occasional OT
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Reports to: Customer Service Manager
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Department: Dental
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Employment Status: Full Time
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Supervisory Responsibilities:
No
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Date Created/Last Evaluated: 2024
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Summary
The Dental Customer Service Representative is responsible for handling incoming calls from members, providers, brokers and group administrators to verify eligibility, verify benefits, explain EOB’s, research claim payments and answer general questions in a call center environment.
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Qualification Requirements: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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Minimum Qualifications
- High School Graduate or General Education Degree (GED)
- At least 2 years of related experience
- Dental terminology experience, preferred
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Knowledge, Skills and Abilities
- Excellent verbal and written communication skills required
- Ability to utilize the available time to organize and complete work within given deadlines
- Ability to meet company metrics
- Ability to work independently with minimal supervision
- Ability to communicate clearly and concisely in spoken and written word
- Ability to take care of customers' needs while following company procedures
- Ability to pay attention to the minute details of a project or task
- Ability to get along well with a variety of personalities and individuals
- Ability to remain calm under pressure
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Essential Functions
- Confer with customers by telephone to provide information about dental services, eligibility and plan benefits
- Ensure department metrics are met by call volume and minimum talk time. Call monitoring must verify minimum number of errors and customer complaints
- Remain calm when speaking with callers who may become upset
- Keep records of customer interactions and transactions, record detail of inquiries, complaints, and comments in the system, as well as any actions taken
- Check to ensure that appropriate changes were made to resolve customer’ problems
- Refer unresolved customer grievances to designated departments for further investigation
- Documents all calls in a clear and concise manner
- Obtain and examine all relevant information to assess validity of complaints and to determine possible causes, such as eligibility, and handle claims questions regarding payments or denials
- Review dental insurance policy terms to determine whether a particular service is covered by insurance
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Physical Demands
While performing the duties of this job, the employee is regularly required to talk or hear. Heavy phone usage and use of computer equipment. This is a sedentary role.
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Work Environment
Remote work-from-home position. Requirements are a dedicated workspace with minimal distractions.
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