Customer Advocate (Federal)

Delta DentalRancho Cordova, CA
1d$23 - $31

About The Position

Act as the primary point of contact for Federal Services division. This position will be responsible for responding to customer inquiries on eligibility, enrollment, billing and claims. In addition, have the ability to communicate policies. Provide excellent service to customers with information in regards to eligibility, enrollment, billing and benefits with emphasis on customer retention. Complete enrollments, account adjustments, payment and claims processing to providers, current and prospective members.

Requirements

  • Effective oral communication skills to handle sensitive incoming customer calls with emphasis on customer retention
  • Customer service-oriented skills and attitude for internal customers
  • Self-motivated and team-oriented
  • PC skills and keyboarding skills to efficiently handle incoming inquiries
  • High school diploma or GED and one year dental, call center/customer service or Dental Assisting certificate or two years of dental office and/or training; or equivalent combination of education and experience
  • Ability to pass Customer Service Associate V test
  • Knowledge of basic dental terminology
  • Ability to pass position test if applicable
  • Must be able to work regular overtime as required
  • MS Word & Excel
  • Ability to professionally represent Delta by clearly communicating complex policies and procedures to our customers
  • Ability to manage stress
  • Ability to adhere to performance standards as defined by management
  • Ability to handle multiple concurrent tasks during emotional interfaces with customers
  • Ability to complete training requirements
  • Ability to respond to requests by customers in a professional and positive manner
  • Ability to prioritize work and follow through
  • Ability to handle detailed work
  • Ability to respond quickly and accurately to questions
  • Ability to handle constant customer contact/forced workflow distribution
  • Ability to work expanded business hours, including early morning, late evening, and weekends
  • Ability to handle change management philosophy
  • Ability to hear voice communications
  • Visual acuity to read computer screens and claim forms
  • Ability to reach and twist to access reference materials and forms
  • Ability to wear a headset during working hours
  • Ability to pass Customer Service Associate basic competency test (includes CS skills, grammar/diction, basic math, written and verbal)
  • Ability to complete CS skills training and testing

Nice To Haves

  • MS Office Professional preferred

Responsibilities

  • Respond to phone and written inquiries & requests from potential enrollees, enrollees, and providers via various mechanisms
  • Process enrollment transactions and changes
  • Access a variety of hard copy and online systems or applications to analyze and determine appropriate responses; forward screened inquiries to appropriate individuals or departments for follow-up; perform updates and process transactions via PC application or online system
  • Set up forms for processing supplemental payments, correcting calculations, or making key changes and edits; perform claims re-adjudication, billing/premium collection, eligibility for enrollment, and modifications to existing member accounts
  • Maintain personal daily performance standards and requirements
  • Participate in training programs
  • Participate in marketing programs and/or outreach to all customers, including subscribers, potential subscribers, and dental professionals

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What This Job Offers

Job Type

Full-time

Career Level

Entry Level

Education Level

High school or GED

Number of Employees

1,001-5,000 employees

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