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Customer Care Representative
Posted on Dec. 24, 2024
- Remote, United States of America
- No Salary information.
- Full Time

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- Training Schedule: Mon- Fri - 8:00am -4:30pm CST - After Training: Mon – Fri 7:00am – 3:30pm or 8:30am – 5:00pm CST
- Please know hours of operation are 7:00am - 8:00pm CST so shift could flex based on business need.
- Fully Remote Role
- $17 and Up depending on experience
- $2/hour differential on Mon/Tues
- Exceptional Professional Growth
- Career growth in an inclusive culture
- Paid training
- Health benefits
- 401(k)
- Servicing our Dental and Vision callers with information regarding their eligibility, benefit coverage, authorizations, claims, and assisting them with locating a provider in their area,
- Utilize knowledge of claim adjustments and resubmission processes to determine appropriate resolution to provider requests.
- Provide feedback to Provider Relations staff on high-level claim issues including but not limited to issues with reimbursement schedules or conflicting information to ensure providers receive a prompt resolution.
- Support enrollment activities including but not limited to assigning primary care providers, and updating third party insurance information.
- Act as liaison between our organization and the client’s Member Services staff to resolve issues such as eligibility and filing appeals and grievances.
- Provide updates to providers with questions regarding the status of their credentialing application.
- Recognize provider questions that could be handled through the use of the provider web portal and provide education to these callers on the benefits of utilizing the technology available.
- Ensure all calls are answered according to company and client guidelines.
- Accurately document call information and resolution in our internal systems.
- Apply effective diffusion techniques when necessary to ensure our customers feel heard, valued and supported.
- Properly identify issues that need to be escalated appropriately to the leadership team.
- Provide recommendations on system enhancements and process improvements to management.
- Keep our Provider Relations team updated with provider manual discrepancies, change in locations or any other provider related issues.
- Participate in departmental projects when applicable.
- Required Level of Education, Licenses, and/or Certificates
- High school diploma or equivalent.
- Required Level of Experience
- 1 -3 years of job related customer service experience within industries such as healthcare, call center, banking or retail.
- Required Knowledge, Skills, and Abilities
- Basic knowledge of Microsoft Office products including but not limited to Word, Excel, and Outlook.
- Ability to work occasional overtime as needed.
- Excellent listening and communication skills.
- Superior customer service skills including the natural ability to provide empathy.
- Strong data entry/typing skills.
- Strong navigation skills and the ability to multi-task.
- Excellent attention to detail.
- Critical thinking skills to quickly analyze and clearly understand a specific request or customer need and then leverage knowledge and resources to provide the appropriate solutions.
- Preferred Level of Experience
- 1+ years of job related customer service experience within the dental, vision or medical industry.
- Previous experience working in a virtual environment.
- Understanding of dental, vision and/or medical insurance terminology.
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