<p><strong>Important things YOU should know:</strong></p><ul><li>Fully remote opportunity</li><li>Training schedule (Initial 3 weeks) : 8:00am - 4:30pm  CST Monday – Friday </li><li>Work schedule (after training):    8:00am - 2:00pm CST   Monday - Friday </li><li>Hours of operation:  7:00am - 10:00pm CST Monday - Friday so shift could flex based on business need</li><li>$2.00/hour differential on Mon/Tues</li><li>Occasional evenings, weekends and holidays possible during Annual Medicare Open Enrollment: 10/1 - 3/31</li><li>Exceptional professional growth in a fun rewarding environment</li></ul><p><strong>What will YOU be doing for us? </strong>  </p><p>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.</p><p><strong>What will YOU be working on every day?  </strong></p><ul><li>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,</li><li>Utilize knowledge of claim adjustments and resubmission processes to determine appropriate resolution to provider requests.</li><li>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.</li><li>Support enrollment activities including but not limited to assigning primary care providers, and updating third party insurance information.</li><li>Act as liaison between our organization and the client’s Member Services staff to resolve issues such as eligibility and filing appeals and grievances.</li><li>Provide updates to providers with questions regarding the status of their credentialing application.</li><li>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.</li><li>Ensure all calls are answered according to company and client guidelines.</li><li>Accurately document call information and resolution in our internal systems.</li><li>Apply effective diffusion techniques when necessary to ensure our customers feel heard, valued and supported.</li><li>Properly identify issues that need to be escalated appropriately to the leadership team.</li></ul><p>Additional Responsibilities:</p><ul><li>Provide recommendations on system enhancements and process improvements to management.</li><li>Keep our Provider Relations team updated with provider manual discrepancies, change in locations or any other provider related issues.</li><li>Participate in departmental projects when applicable.</li></ul><p><strong>What qualifications do YOU need to have to be GOOD candidate?  </strong></p><p>Required Level of Education, Licenses, and/or Certificates</p><ul><li>High school diploma or equivalent.</li><li>Required Level of Experience</li><li>1+ years of job related customer service experience within industries such as healthcare, call center, banking or retail.</li></ul><p>Required Knowledge, Skills, and Abilities</p><ul><li>Basic knowledge of Microsoft Office products including but not limited to Word, Excel, and Outlook.</li><li>Ability to work occasional overtime as needed.</li><li>Excellent listening and communication skills.</li><li>Superior customer service skills including the natural ability to provide empathy.</li><li>Strong data entry/typing skills.</li><li>Strong navigation skills and the ability to multi-task.</li><li>Excellent attention to detail.</li><li>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.</li></ul><p><strong>What qualifications do YOU need to be a GREAT candidate?</strong></p><p>Preferred Level of Experience</p><ul><li>1+ years of job related customer service experience within the dental, vision or medical industry.</li><li>Previous experience working in a virtual environment.</li><li>Understanding of dental, vision and/or medical insurance terminology.</li></ul>