Role Description Our Customer Service Representatives must have strong problem-solving skills, coupled with the natural ability to provide empathy for the customer – always taking the time to patiently listen and understand their questions to help find a viable solution, while providing them with a memorable customer experience. - Servicing our Dental and Vision inbound 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. Additional Responsibilities: - 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. Qualifications - High school diploma or equivalent. - 1+ years of job related customer service experience within industries such as healthcare, call center, banking or retail. - 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. Requirements - 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. Benefits - Fully remote opportunity. - Training schedule: 8:00am - 4:30pm Monday – Friday CST for the 1st 12 weeks. - Work schedule (after training): Multiple opportunities available with ranging start times from 7:00am CST to 10:30am CST Mon - Fri. - Hours of operation: 7:00am - 10:00pm CST Monday - Friday so shift could flex based on business need. - $2.00/hour differential on Mon/Tues. - Occasional evenings, weekends and holidays possible during Annual Medicare Open Enrollment: 10/1 - 3/31. - Exceptional professional growth in a fun rewarding environment.