Customer Service Representative
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Role Overview
Responds to questions from members, groups, and dental offices regarding products and plans. This position requires resolution of problems with claims, complaints and appeals with dentists, and group enrollment. Works with a wide variety of internal resources to resolve issues to ensure customer satisfaction.
Full Job Posting
POSITION SUMMARY
Responds to questions from members, groups, and dental offices regarding products and plans. This position requires resolution of problems with claims, complaints and appeals with dentists, and group enrollment. Works with a wide variety of internal resources to resolve issues to ensure customer satisfaction.
Essential Functions
Responds to current and prospective customer questions and complaints/appeals in a timely and empathetic manner via telephone or web inquiries
Researches of complaints, appeals, claims, processing issues, benefit and eligibility requests and all communication with external and internal customers
Collaborates with Operations to review claims and decisions regarding payment
Answers inquiries from dental offices to clarify coverage levels, identifies allowable procedures, and resolves claims payment issues
Builds a strong rapport with dental office staff, groups and members to ensure a positive perception of the company within the community
Performs other duties as assigned
Requirements
- High school diploma or equivalent, college degree preferred
- Previous customer contact experience (i.e. customer call center, dental office experience, or experience within a similar insurance system)
- Medical or dental insurance experience, dental office or clinical assistant experience a plus
- Excellent communication skills (verbal and written)
- Attention to detail and accuracy essential
Work Environment / Physical Demands
Typical office environment
About Delta Dental of Rhode Island
Provides dental insurance and manages dental benefit plans.
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