Remote Healthcare Customer Service Representative

Remote Call Center Representative

• The pay rate is $16 per hour, which may be below your state’s minimum wage. Please take this into consideration when applying.

• Training is 5 weeks classroom and 2 weeks nesting.

• Successfully complete a mandatory paid training program with 100% attendance.

• Hours of operation: Monday – Sunday 7:30am – 11:00pm EST

• Medical, dental and vision benefits are available on the 1st day of employment.

• Paid time off is accrued after 180 days (about 6 months) of employment.

• Successfully navigate 6 systems and average 32 calls per day.

• Respond to inbound inquiries regarding dental benefits, eligibility, claims, appeals, grievances, and provider searches for both Commercial and Medicare plans.

• Provide uniform interpretation and clarification of dental benefits, policies, and procedures to members, providers, and employer groups.

• Actively attempt to resolve member or provider concerns by investigating issues, contacting appropriate parties, and documenting all interactions accurately within the billing system.

• Investigate verbal complaints regarding billing, claims, or services rendered; escalate service failures to appropriate internal departments for follow-up and resolution.

• Retrieve and send written correspondence, including plan brochures, provider directories, and other printed materials as needed.

• Meet or exceed established ACD (Automated Call Distribution) system call volume and quality performance goals.

• Achieve all assigned individual monthly performance metrics.

• Maintain current and thorough knowledge of all Member Services policies, procedures, and dental plan updates.

• Perform additional duties and responsibilities as assigned by management.

• Successfully complete customer service assessment & typing test.

• High school diploma, GED, or college degree

• At least 1 year of Call Center experience preferred.

• 1 year of face-to-face customer service experience.

• Knowledge of and prior experience in the Dental, Medical or Managed Care industry is preferred.

• Must possess the following characteristics: self-motivation, resourceful, detail-oriented, sense of accountability and must be a team player.

• Must possess strong skills in the following areas: organizational, time management, written and verbal communication, analytical, and problem solving.

• Proficiency in Microsoft Word, Microsoft Outlook, and Internet Explorer.

• Effective communication skills over the phone.

• Ability to deal with problems involving several concrete variables in standardized situations.

• Successful completion of background check is required for this position.

• We provide all equipment. (Computer, Monitor, Mouse, Keyboard, Headset, Ethernet Cord, Power Cables)

• You must have a home internet connection of 10 Download and 3 Upload Speed (you may do a quick check through https://www.speedtest.net/

• Must be able to hardwire your work computer directly to your home modem via ethernet. Ensure the available connection meets the minimum bandwidth requirements to perform your job function. Satellite internet and wireless internet are not acceptable.

• Must have a distraction free and secure work environment. (Workspace must be clutter free, free of distraction, no one is allowed in workspace during working hours, no writing utensils, or unauthorized electronics in the work area).

• It is important that you complete the application in a timely manner to be considered for the role.

• Your local library, shipping store or search, ‘public computers near me’ if you do not have a computer.

Important:

Due to varying state and local minimum wage laws, we are currently only able to hire candidates residing in states where our compensation structure complies with applicable wage regulations. As a result, we may be unable to consider applicants from certain states or municipalities at this time.

We are currently NOT hiring in the following geographies, including but not limited to: