Government Programs Customer Service Representative

Delta-Dental; Farmington Hills (MI); Remote; USD 32,000 - 52,000; Full time

Job summary

Delta Dental of Michigan, Ohio, and Indiana is seeking a Government Programs Customer Service Representative in Farmington Hills, MI. The role involves assisting members, providers, and clients with questions across multiple channels, including phone, email, fax and mail, while ensuring accuracy of eligibility, benefits and claims information.

Position requires a high school diploma (associate degree preferred) and at least two years of customer service experience in a setting using software

Qualifications

• High school diploma or equivalent required; associate degree preferred.
• Two years of customer service experience in a business environment.
• Experience with software applications and Windows operating systems.
• Must complete customer service assessments with minimum scores (as specified).

Responsibilities

• Respond to member, client and provider inquiries via multiple channels professionally.
• Communicate eligibility, benefit, claim status, and payment information clearly.
• Document calls in the CRM system with all relevant details.
• Adhere to regulatory requirements and meet quality metrics.

Skills

Customer service

Call center experience

Windows familiarity

Education

High School Diploma or equivalent

Associate degree in business administration or related field preferred

Tools

CRM software

Windows

Job description

Job Title:Government Programs Customer Service RepresentativeNumber of Positions:4Location:Farmington Hills, MILocation Specifics:Fully RemoteJob Summary:Candidates must reside in Michigan within a reasonable commuting distance of our Farmington Hills office for team meetings, collaborative sessions, and training.At Delta Dental of Michigan, Ohio, and Indiana we work to improve oral health through benefit plans, advocacy and community support, and we amplify this mission by investing in initiatives that build healthy, smart, vibrant communities. We are one of the largest dental plan administrators in the country, and are part of the Delta Dental Plans Association, which operates two of the largest dental networks in the nation.At Delta Dental, we celebrate our All In culture. It’s a mindset, feeling and attitude we wrap around all that we do – from taking charge of our careers, to helping colleagues and lending a hand in the community.Typical AssignmentsPromptly and professionally responds to member, client and provider questions through multiple channels, including, but not limited to telephone, email, fax and U.S. mail communication using proper etiquette, grammar, punctuation, etc.Clearly and accurately communicates all eligibility, benefit, claim status and payment information related to caller’s questionsProperly identifies the reason(s) for the call and provides appropriate resolution to inquiries and complaints within specified timeframes and guidelines established by regulatory agencies or client contracts.Informs and assists callers with grievance and the claims appeals processes, as necessaryClearly, accurately and thoroughly documents information in the customer relationship management system to ensure all relevant details of the phone call are captured.Understands the importance of adhering to regulatory requirementsMeets or exceeds quality standards as required for positionMeets or exceeds call center metrics as required for positionEnters and adjusts claims as required#LI-RemoteMinimum Requirements:Bidding RequirementsEmployees must have the ability to work an assigned eight (8) hour schedule starting as early as 7:55 a.m. and ending as late as 11:00 p.m., Monday through FridayPossess a high school diploma or equivalent, with an associate’s degree in business administration or a related field preferredTwo years of customer service experience in a business environment that requires the use of a software application to assist customers, preferably in a call center assisting Medicare and/or Medicaid enrolleesDemonstrated knowledge of personal computers and software applications (including Windows) through previous experience and/or courseworkSuccessful completion of the customer service simulation assessment with a minimum score of 62 out of a possible 100 (assessment waived if candidate previously passed test while at Delta Dental or if previously held Customer Service Trainee, Customer Service Advisor, or Customer Service Associate position)Successful completion of the customer service multitasking and call logging assessment with a minimum score of 65 out of a possible 100Successful completion of the customer service email composition assessment with a minimum score of 62 out of a possible 100The company will provide equal employment and advancement opportunity within the context of its unique business environment without regard to race, color, religion, gender, gender identity, gender expression, age, national origin, familial status, citizenship, genetic information, disability, sex, sexual orientation, marital status, pregnancy, height, weight, military status, or any other status protected under federal, state, or local law or ordinance.