Government Programs Customer Service Representative

  • Delta Dental of Michigan
  • Remote
  • Oct 14, 2021
Full time Customer Service

Job Description

Delta Dental of Michigan, Ohio, and Indiana is a leader in dental benefits, plus so much more.

We improve oral health through benefit plans, advocacy and community support, and our corporate giving builds healthy, smart, vibrant and inclusive communities. We devote our time, talents and financial resources to improve oral and overall health, and we invest in initiatives that support youth, education, workforce and economic development.

We are a force for good--part of the reason why employees find working at Delta Dental fulfilling.

Delta Dental companies nationwide comprise the Delta Dental Plans Association, which provides coverage to more than 80 million Americans and operates two of the nation's largest networks of participating dentists.

For more, visit www.deltadentalmi.com and www.buildingbrighterfutures.com, and apply online at www.deltadentalmi.com/careers.

Typical Assignments:

* Promptly and professionally responds to member, client and provider questions through multiple channels, including, but not limited to telephone, email, fax and U.S. mail communication using proper etiquette, grammar, punctuation, etc.

* Clearly and accurately communicates all eligibility, benefit, claim status and payment information related to caller's questions.

* Properly identifies the reason(s) for the call and provides appropriate resolution to inquiries and complaints within specified timeframes and guidelines established by regulatory agencies or client contracts.

* Informs and assists callers with grievance and the claims appeals processes, as necessary.

* Clearly, accurately and thoroughly documents information in the customer relationship management system to ensure all relevant details of the phone call are captured.

* Understands the importance of adhering to regulatory requirements.

* Meets or exceeds quality standards as required for position.

* Meets or exceeds call center metrics as required for position.

* Enters and adjusts claims as required.

This description is intended to indicate the general responsibilities and level of work difficulty that will be required of positions given this title, and should not be construed as declaring what the specific duties and responsibilities of any particular position should be.