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Customer Service - Work at Home
Overview
Responsibilities
- Resolving coordination of benefits inquires by analyzing patient activity (including enrollment, third party liability, claims attachments).
- Having a comprehensive understanding of insurance coverage and being able to interpret and communicate accurate information.
- Thoroughly and completely documenting all customer interactions.
- Educating customers and dental professionals on eligibility, benefits, claims payment, and authorizations.
- Educating on the usage and benefits of self-service tools.
- Assisting members on gaining access to care by locating a network dentist or assignment to a primary care dentist.
- Directing inquires to necessary departments or individuals when the resolution of the inquiry is beyond the span of control for this role.
- Responding to customer inquiries in a courteous and professional manner.
- Researching and consistently providing accurate information to resolve all member and provider inquiries through verbal and written communications through all channels including phone, email, web portal, and chat interactions.
- Responding to and resolving internal and external complex customer inquiries.
- Resolving claim payment inquiries by researching and analyzing patient activity and determining appropriate action to be taken.
- Taking ownership of the resolution and setting expectation for follow up.
- Ensuring resubmissions, stop payments, and voids are appropriately handled.
- Meeting or exceeding individual, department, and client specific goals.
- Understanding and adhering to all client administrative and contractual policies and procedures.
- Suggesting ways to improve the service delivery processes contributing to the success of the organization.
- Other duties as assigned.
Qualifications
- Private, distraction free workspace (not a shared/common area of the home)
- Hard wired ethernet internet connection with minimum speeds of 50 Mbps Download / 10 Mbps Upload. (5G, hotspots, and satellite internet not supported)
- Active wireless phone service
- Must remain on camera during working hours
- Experience in healthcare or related industry experience
- Medical/Dental terminology knowledge experience
- Medicare/Medicaid knowledge
- Claims/Billing and coding experience
- Medical, Dental, and Vision insurance
- 401(k) Retirement Savings Plan
- Paid Time Off
- Paid T-Mobile cell service
- Employee referral program
- Employee PerkSpot (discounts on retail, hotel, food, restaurants, car rental and much more!!)
