Remote Government Programs Customer Support Specialist

Delta Dental of Michigan; United States; Remote; USD 38,000 - 48,000; Full time

Job summary

Delta Dental of Michigan is seeking a Government Programs Customer Service Representative to support members, providers and clients with benefits and claims information. Location: Farmington Hills, MI with remote work options.

Candidates will respond across multiple channels, verify eligibility and benefits, document calls in the CRM, and help callers navigate grievances and appeals while meeting quality and call-center metrics established by regulatory requirements.

Qualifications

• High school diploma or equivalent; associate degree preferred.
• Two years of customer service experience in a business environment that requires software to assist customers, preferably in a call center for Medicare/Medicaid enrollees.
• Demonstrated knowledge of personal computers and software applications (including Windows).
• Successful completion of specified customer service assessments with indicated minimum scores.

Responsibilities

• Respond to member, client, and provider questions through multiple channels (phone, email, fax, U.S. mail) with proper etiquette and accuracy.
• Clearly communicate eligibility, benefits, claim status, and payment information.
• Identify reasons for calls and provide timely resolutions within regulatory/client guidelines.
• Assist callers with grievances and claims appeals processes as needed.
• Document interactions in the CRM system with relevant details of the call.
• Adhere to regulatory requirements and meet quality and call center metrics.

Skills

Customer service

Communication

Multitasking

Computer literacy

Education

High school diploma

Associate degree in business administration

Tools

Windows

CRM system

Job description

Delta Dental of Michigan is seeking a Government Programs Customer Service Representative to support members, providers and clients with benefits and claims information. Location: Farmington Hills, MI with remote work options.

Candidates will respond across multiple channels, verify eligibility and benefits, document calls in the CRM, and help callers navigate grievances and appeals while meeting quality and call-center metrics established by regulatory requirements.