Job Details

** MUST HAVE 2 years of high-volume call center experience **

** MUST HAVE 1 year of healthcare experience **

"MUST LIVE IN ARIZONA ONLY"

PAY: $18 - $18.50 (Bilingual in Mandarin or Spanish)

SHIFT: Mon - Fri / 10am - 8pm CT

The Customer Service Representative position interacts with customers to provide and

process information in response to general inquiries, concerns, and requests about

products and services across multiple lines of business.

PRIMARY JOB RESPONSIBILITIES:

• Assist providers by resolving coordination of benefits inquiries by analyzing patient activity (including enrollment, third-party liability, and claims attachments).
• Interpret and communicate accurate insurance coverage by having a comprehensive understanding of the process.
• Thoroughly and completely document all customer interactions.
• Educates customers and dental professionals on eligibility, benefits, claims payment, and authorizations.
• Provides direction on the usage and benefits of self-service tools.
• Assist members in gaining access to care by locating a network dentist or assignment to a primary care dentist.
• Appropriately routes inquiries to the necessary departments or individuals when the resolution of the inquiry is beyond the span of control of this role.
• Responds to customer inquiries courteously and professionally.
• Researches assistance requested and consistently provides accurate information to resolve internal and
• external member and provider inquiries via verbal and written communications through all channels including phone, email, web portal, and chat interactions.
• Resolves claim payment inquiries by researching and analyzing patient activity and
• determines appropriate action to be taken.
• JOB REQUIREMENTS:
• High School Diploma or Equivalent.
• 2 years of experience in a high-volume customer service environment.
• 1-year experience in the health insurance industry.
• Experience utilizing multiple software applications simultaneously.
• Ability to set up computer equipment and troubleshoot issues with minimal assistance.
• Proven professional verbal and written communication skills.
• Ability to efficiently operate a computer and knowledge of Microsoft Office applications. Strong organizational skills and attention to detail.

Preferred Experience Needed:

1. Medical/Dental terminology knowledge experience.
2. Medicare/Medicaid knowledge.
3. Claims/Billing and coding experience.
4. Experience with Cisco phone system a plus.