To provide polite, accurate and professional customer service related to eligibility, dental benefits, and claim payment; performs claim and benefit research, reconciliation, adjudication, data entry, adjustments, and related reporting. Respond to written inquiries in a timely and professional manner.
Role model and live the company values and behaviors. Know the company vision, mission, and objectives and continually communicate and reinforce these to fellow Team Members.
Responds to member inquiries via telephone, e-mail, or chat.
Open, sort, and scan incoming claim and non-claim related mail.
Completes timely and accurate entry of claims related data including the auditing, coding, and entry of claims.
Maintains the required performance standards relating specifically to Customer Services and claims accuracy.
Maintains files and databases as required by department policies and procedures.
Coordinates inquiries requiring additional information with other departments in a cooperative, efficient, and professional manner.
Perform other related assigned duties as necessary to complete the Primary Job Responsibilities as described above.
Foster, encourage, and reward a fun, positive, successful, values-based culture!
Completes timely and accurate entry of claims related data including the auditing, coding, and entry of claims at or above 95%.
Quality Scoring for telephone calls at 3.0 or above.
High School Diploma
Good computer skills and working knowledge of Microsoft applications sufficient to independently perform claim related functions and produce customer communications; the ability to provide consistent, efficient, accurate, and quality customer service; excellent time management skills and ability to manage multiple tasks with multiple time deadlines also required; effective oral and written communication skills; ability to lift 30 pounds.
Bilingual a plus
One (1) year experience in public relations or customer service, preferably in the group benefits/insurance field. Will accept any suitable combination of education, training, or experience.
High School diploma or GED.
...DESIGN RESEARCHER People are endlessly fascinating, don't you think? We do. Conifer Research is seeking a curious and empathetic Design... ...drawing from established methodologies for ethnography, remote research, evaluative testing, and co-creation. Translate research...
...Propio Language Services provides critical interpreting and translation services that improve... ...We have an immediate need for a Remote Spanish Contract Interpreters for our OnDemand... ...required for various clients, such as medical, legal, social services, etc. Requirements...
...Job Description Join the Providence ExpressCare Portland team as a full-time nurse practitioner or physician associate. As a Mission based, community focused service, the clinics provide the perfect work life balance with a 3-day week schedule. ExpressCare serves...
...join an organization that invests in you as a(an) Registered Nurse L&D and Mother Baby (Womens Float Pool)? At Overland Park Regional... ...s & Childrens healthcare services. We offer the regions only Maternal Fetal Health Center to care for critically ill mothers and...
...A global recruiter collaboration platform is offering a remote recruiter opportunity allowing you to work from anywhere. Independent recruiters can earn placement fees ranging from $3,000 to $11,000 per successful placement without needing to find clients. Ideal for agency...