Job Summary
Answer all incoming inquiries in a professional and efficient manner.
Inquiries may consist of phone calls, written correspondence, emails, and/or internal requests
Primary Job Responsibilities
Answer telephone inquiries regarding eligibility, benefits, claim status, provider status, membership, and billing from subscribers, providers, group administrators, and agents/brokers.
Research and respond to complex customer inquiries including telephone, email, written inquiries and voicemails from subscribers, providers, group administrators, and agent/brokers.
Document in detail each customer encounter in ETS call resolution system.
Research and determine if a claim has been processed incorrectly; adjust claim accordingly, this includes refunds.
Meet and maintain production standards, counts and inquiry response turnaround times.
Participate in on-going training programs and provide support to other departments, as needed.
Identify, report, and document all system discrepancies to management.
Maintain positive and professional attitude when dealing with internal and external customers in on-going effort to ensure excellent customer service.
Protect all private health information in accordance with HIPAA guidelines.
Handle escalated customer inquiries when manager/team lead is not available
Perform other related assigned duties as necessary to complete the Primary Job Responsibilities as described above.
Requirements:
Minimum Qualifications
Position requires a high school diploma or equivalent.
Two years of prior customer service experience required.
Prior experience in dental/health insurance or dental office a plus, but not required.
Kentucky Health and Life Insurance license is desired.
Will accept any suitable combination of education, training, or experience.
Position requires strong communication skills; strong organizational/time management skills and multi-tasking abilities; intermediate analytical and critical thinking skills; excellent interpersonal skills; ability to respond quickly and accurately to requests by customers in a professional and positive manner; ability to resolve complex problems and use independent judgment.
Delta Dental of Kentucky is an Equal Opportunity Employer.
All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, disability, or veteran status.
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