Job Description

Overall Responsibility: To deliver high quality customer service to doctors or doctor's office staff, members, community partners and plan sponsor representatives in a professional, respective and helpful manner. Process claims in a timely, accurate manner.

Permanent position - $50K with Benefits - Hybrid after training. Minimum of 2 days in office.

Key responsibilities and accountabilities:
~ Respond to inbound telephone calls, faxes and emails from doctors or doctor's office staff, and plan sponsor representatives in a timely and professional manner;
~ Respond to inbound telephone calls, faxes and emails from members or member representatives in a timely and professional manner;
~ Process dental claims on system for all clients;
~ Process claim corrections from daily EDI reports;
~ Document communications with doctors and doctor's office staff, and plan sponsor/employer representatives;
~ Document communications with members and member representatives;
~ Respond to claim inquiries from subscribers, doctors and plan sponsor/employer representatives in a timely and professional manner;
~ Respond to benefit coverage inquiries from members and member representatives in a timely and professional manner;
~ Respond to eligibility inquiries from subscribers, doctors and plan sponsor/employer representatives in a timely and professional manner;
~ Maintain department productivity and quality expectations;
~ Maintain knowledge of dental plan designs, exclusions, limitations and exceptions for each client;
~ Adhere to all process and procedural guidelines;
~ Any other duties as assigned

Skills and Attributes:
~ Ability to provide outstanding service
~ Ability to work independently to achieve goals and objectives within defined timeframes
~ Ability to process information through computer systems
~ Ability to adjust priorities and manage time wisely in a fast-paced environment;
~ Ability to communicate in a clear, concise, understandable manner, and listen attentively to others;
~ Ability to prioritize and manage workflow;
~ Ability to meet deadlines;
~ Team player; ability to get along well with others and function as part of a work group;
~ Excellent data entry skills;

Experience:
~ Customer Service
~ Basic knowledge of MS Windows, MS Word, MS Excel;
~ Strong organizational skills;
~ Multilingual a plus.