Customer Service Representative

Delta-Denta; Providence (RI); On-site; USD 40,000 - 50,000; Full time

Job summary

Delta-Denta in Providence, RI is seeking a Customer Service Representative to assist members, dental offices, and groups with products and plans. You will resolve issues related to claims, appeals, and enrollment, coordinating with internal resources to ensure satisfaction.

The role emphasizes empathetic communication, attention to detail, and teamwork with Operations to review payments and coverage. High school diploma required; prior call center or dental/insurance experience is a plus.

Qualifications

• High school diploma or equivalent; college degree preferred.
• Previous customer contact experience in call center or dental/insurance setting.
• Strong communication and interpersonal skills.

Responsibilities

• Responds to current and prospective customer questions and complaints/appeals in a timely and empathetic manner via telephone or web inquiries
• Researches 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

Skills

Verbal and written communication

Attention to detail

Customer service experience

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

2 days ago Requisition ID: 1075

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