Bilingual Customer Service Representative

About the role

Our vibrant team thrives on support, good vibes, and leaders who actually listen. You’ll make real connections, build new skills, and grow your career in a place that celebrates you.

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.
• Aiding 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.
• Safeguarding resubmissions, stop payments, and voids are appropriately handled.
• Maintaining 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

• Fluent in both English and Spanish, with the ability to accurately translate and communicate medical terminology.
• A High School Diploma or Equivalent.
• 2 years experience in a customer service environment.
• Ability to multi-task using multiple applications simultaneously.
• Ability to set-up computer equipment and troubleshoot issues with minimal assistance.
• Professional verbal and written communication skills.
• Ability to operate a computer and knowledge of Microsoft Office applications.
• Strong organizational skills and attention to detail.
• Ability to work independently and with a team.
• Ability to learn quickly and adapt to a fast pace production environment.
• Cooperative, professional and effective interaction skills.
• Critical thinking and problem solving skills.
• Ability to tolerate repetitive work without compromising accuracy and service levels.
• Attend additional training as requested/deemed necessary.

Must Haves For Work At Home

• 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.

Eligible States

• Arkansas
• Delaware
• Florida
• Georgia
• IDaho
• Indiana
• Kansas
• Kentucky
• Louisiana
• Michigan
• North Carolina
• Oklahoma
• Pennsylvania
• South Carolina
• Tennessee
• Texas
• Vermont
• Virginia
• West Virginia
• Wisconsin
• Wyoming

Preferred Experience

• In healthcare or related industry experience.
• Medical/Dental terminology knowledge experience.
• Claims/Billing and coding experience.