Member Services Representative

Willamette Dental Group; Hillsboro (OR); On-site; USD 36,000 - 48,000; Full time

Benefits offered by this job

medical

dental and vision insurance

tuition reimbursement

flexible spending accounts

401(k) retirement plan with 5% match

accidental death and dismemberment

life insurance

voluntary disability insurance

commuter benefits

Two complimentary Fig scrubs (clinical

employee assistance program

Job summary

Willamette Dental Group is seeking a Member Services Representative to answer member inquiries regarding eligibility and benefits. You will educate members on dental coverage, communicate policies, and resolve issues while escalating complex questions as needed.

The role requires a high-volume call center background and strong communication to diverse members. It offers comprehensive benefits and opportunities for outreach initiatives within the company.

Qualifications

• High School Diploma or equivalent and two years of customer service experience in a high-volume call center.
• Experience in communicating benefits to members with diverse backgrounds and cultures preferred.

Responsibilities

• Respond to Member calls in a courteous and professional manner, answering questions regarding membership eligibility, benefits, claims, notices of action, grievance processes, policies and procedures.
• Educate members on dental benefits guidelines and Willamette Dental Group systems, processes and policies.
• Assess and resolve problems within authority; escalate complex questions to higher authority.
• Identify complaints and facilitate processes with Practice or Member Services Grievance, Appeal and Care Coordination.
• Support various outreach programs.

Skills

Customer service

Communication

Education

High School Diploma or equivalent

Job description

The Member Services Representative communicates with members via incoming calls to efficiently and effectively answer membership questions regarding benefit eligibility, performs outreach communications and handles all inquiries within the scope of the position’s responsibility.

Essential Position Functions

• Respond to Member calls in a courteous and professional manner, answering questions and inquiries regarding membership eligibility, benefits, claims, notice of actions or adverse benefit determinations, grievance processes, policies and procedures. Completes forms and other paperwork as needed, and document all incoming and outgoing calls.
• Educate members on the guidelines of their dental benefits with the company and their insurance partners. Understand and clearly communicate Willamette Dental Group systems, processes, policies and treatment services to members.
• Assess and resolve problems within the scope of authority; escalates complex questions or problems to more experienced representatives or higher authority level.
• Identify complaints and understand how to facilitate the process with the Practice or Member Services Grievance, Appeal and Care Coordination.
• Supports various outreach programs

Education & Experience

High School Diploma or equivalent and two years of customer service experience in a high volume call center; or any equivalent combination of education and/or experience which leads to the ability to perform the essential functions of the position. Experience in communicating benefits to members with diverse backgrounds and cultures preferred.

Compensation

The actual base pay offered to the successful candidate will be based on multiple factors, including but not limited to education, job-related knowledge/skills, experience, geographical location, and internal equity.

This position is also eligible for incentive pay in accordance with the terms of the Company’s plan.

Company Benefits

• medical
• dental and vision insurance
• tuition reimbursement
• flexible spending accounts
• 401(k) retirement plan with 5% match
• accidental death and dismemberment insurance
• life insurance
• voluntary disability insurance
• commuter benefits
• two complimentary pairs of Fig scrubs (clinical roles)
• employee assistance program

Paid Time Off (PTO): Eligible employees will accrue a minimum of 120 PTO hours per employment year in addition to seven paid holidays annually. The Company’s PTO program combines vacation and sick leave, which is more generous than Washington State’s Sick Leave Law. Employees in part-time roles working less than 40 hours per week will accrue PTO on a pro-rated basis.

Physical Requirements

The work is primarily performed while sitting and/or standing, but will require occasional walking, bending, stooping and carrying light items such as papers, books, or other supplies. The incumbent uses a computer and other standard office equipment to complete tasks.

Willamette Dental is an equal opportunity employer.

We provide equal employment opportunities to all employees and applicants for employment without regard to an individual’s race (including physical characteristics historically associated with race), religion, color, age, sex (including pregnancy), national origin, veteran status, disability, marital status, genetic information, sexual orientation, gender identity, pregnancy-related condition, or any other classification protected by applicable federal, state or local laws.

Note:

We comply with the Americans with Disabilities Act and consider reasonable accommodation measures that may be necessary for qualified applicants/employees to perform essential job functions.