Customer Service Representative

Delta Dental of Rhode Island; Northern (KY); Hybrid; USD 37,000 - 52,000; Full time

Job summary

Delta Dental of Rhode Island is seeking a Customer Service Representative in Providence, RI. The role handles member and dental office inquiries, resolves claims issues, and processes appeals to ensure customer satisfaction.

You will work with internal resources and providers to answer questions about products and plans, with emphasis on accuracy and empathy in every interaction.

Qualifications

• High school diploma or equivalent.
• Previous customer contact experience (call center, dental office, or insurance system).
• Medical or dental insurance experience is a plus.
• Excellent communication skills (verbal and written).
• Attention to detail and accuracy essential.

Responsibilities

• Responds to questions and complaints via telephone or web inquiries.
• Researches complaints, appeals, claims, processing issues, benefits and eligibility requests.
• Collaborates with Operations to review claims and payment decisions.
• Answers dental office inquiries to clarify coverage and resolve claims issues.
• Builds rapport with dental offices, groups and members to maintain a positive company image.

Skills

Customer service

Communication skills

Attention to detail

Education

High school diploma or equivalent

College degree preferred

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Customer Service Representative

Providence, RI, US

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