Customer Service - Work at Home

Responsibilities

• Resolve coordination of benefits inquires by analyzing patient activity (including enrollment, third party liability, claims attachments).
• Have a comprehensive understanding of insurance coverage and be able to interpret and communicate accurate information.
• Thoroughly and completely document all customer interactions.
• Educate customers and dental professionals on eligibility, benefits, claims payment, and authorizations.
• Educate on the usage and benefits of self-service tools.
• Absorb and direct inquires to necessary departments or individuals when the resolution of the inquiry is beyond the span of control for this role.
• Respond to customer inquiries in a courteous and professional manner.
• Research and consistently provide 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.
• Respond to and resolve internal and external complex customer inquiries.
• Resolve claim payment inquiries by researching and analyzing patient activity and determining appropriate action to be taken.
• Take ownership of the resolution and set expectations for follow-up.
• Ensure resubmissions, stop payments, and voids are appropriately handled.
• Meet or exceed individual, department, and client-specific goals.
• Understand and adhere to all client administrative and contractual policies and procedures.
• Suggest ways to improve the service delivery processes contributing to the success of the organization.
• Other duties as assigned.

Requirements

• Private, distraction-free workspace (not a shared/common area of the home).
• Active wireless phone service.
• Must remain on camera during working hours.

Qualifications

• Experience in healthcare or related industry.
• Knowledge of medical/dental terminology.
• Experience with Medicare/Medicaid.
• Experience with claims/billing and coding.
• Experience with Medical, Dental, and Vision insurance.
• Participation in 401(k) Retirement Savings Plan.
• Paid time off.
• Paid T-Mobile cell service.
• Employee referral program.
• Employee perk spot (discounts on retail, hotel, food, restaurants, car rental and much more!!).