Customer Care Rep II - Part Time - Fully Remote!

Important things YOU should know

* Fully remote opportunity * Training schedule 8:00am - 4:30pm Monday – Friday CST for the 1st 3 weeks * Work schedule (after training): Multiple opportunities available with ranging start times from 9:00am CST to 11:00am CST Mon - Fri. * Hours of operation: 6:00am - 10:00pm CST Monday - Friday so shift could flex based on business need * $2.00/hour differential on Mon/Tues * Occasional evenings, weekends and holidays possible during Annual Medicare Open Enrollment: 10/1 - 3/31 * Exceptional professional growth in a fun rewarding environment Experience with Dental or Health insurance a preferred plus *

What will YOU be doing for us?

Our Customer Service Representatives must have strong problem-solving skills, coupled with the natural ability to provide empathy for the customer – always taking the time to patiently listen and understand their questions to help find a viable solution, while providing them with a memorable customer experience.

What will YOU be working on every day?

* Servicing our Dental and Vision inbound callers with information regarding their eligibility, benefit coverage, authorizations, claims, and assisting them with locating a provider in their area, * Utilize knowledge of claim adjustments and resubmission processes to determine appropriate resolution to provider requests. * Provide feedback to Provider Relations staff on high-level claim issues including but not limited to issues with reimbursement schedules or conflicting information to ensure providers receive a prompt resolution. * Support enrollment activities including but not limited to assigning primary care providers, and updating third party insurance information. * Act as liaison between our organization and the client’s Member Services staff to resolve issues such as eligibility and filing appeals and grievances. * Provide updates to providers with questions regarding the status of their credentialing application. * Recognize provider questions that could be handled through the use of the provider web portal and provide education to these callers on the benefits of utilizing the technology available. * Ensure all calls are answered according to company and client guidelines. * Accurately document call information and resolution in our internal systems. * Apply effective diffusion techniques when necessary to ensure our customers feel heard, valued and supported. Properly identify issues that need to be escalated appropriately to the leadership team. *

Additional Responsibilities

* Provide recommendations on system enhancements and process improvements to management. * Keep our Provider Relations team updated with provider manual discrepancies, change in locations or any other provider related issues. Participate in departmental projects when applicable. *

What qualifications do YOU need to have to be GOOD candidate?

Required Level of Education, Licenses, and/or Certificates

* High school diploma or equivalent. * Required Level of Experience 1+ years of job related customer service experience within industries such as healthcare, call center, banking or retail. *

Required Knowledge, Skills, and Abilities

* Basic knowledge of Microsoft Office products including but not limited to Word, Excel, and Outlook. * Ability to work occasional overtime as needed. * Excellent listening and communication skills. * Superior customer service skills including the natural ability to provide empathy. * Strong data entry/typing skills. * Strong navigation skills and the ability to multi-task. * Excellent attention to detail. Critical thinking skills to quickly analyze and clearly understand a specific request or customer need and then leverage knowledge and resources to provide the appropriate solutions. *

What qualifications do YOU need to be a GREAT candidate?

Preferred Level of Experience

• 1+ years of job related customer service experience within the dental, vision or medical industry.
• Previous experience working in a virtual environment.
• Understanding of dental, vision and/or medical insurance terminology.