Customer Care Specialist - Pensacola, FL

Dentsply Sirona, Inc•Pensacola, FL

37d•Onsite

About The Position

Under general supervision, the Customer Care Specialist serves as a critical point of contact for patients, caregivers, clinicians, and referral partners with Wellspect’ product portfolio. The role is responsible for accurately processing product orders, verifying insurance and documentation requirements, coordinating with internal and external stakeholders, and delivering a high-quality service experience that supports optimal patient outcomes. The Customer Care Specialist ensures all activities adhere to regulatory, payer, and compliance standards while demonstrating professionalism, efficiency, and compassion in every interaction.

Requirements

Minimum: High School Diploma or equivalent
2+ years of customer service experience analyzing and solving customer problems
Proficiency with Microsoft Office Suite (Word, PowerPoint, Outlook, and Excel), CRM systems, order management platforms, and electronic documentation systems.
Strong understanding of payer requirements, prior authorizations, DME billing practices, and reimbursement models.
Ability to build and maintain productive relationships with both internal and external stakeholders, including clinical partners, referral sources, and patients.
Exceptional communications, organization, and follow-through skills with the ability to manage a high volume of requests.
Demonstrated ability to remain calm, empathetic, and patient-focused while navigating sensitive clinical topics.
Ability to work independently, manage competing priorities, and maintain accuracy in a fast-paced environment.

Nice To Haves

Preferred: Certified Medical Assistant (CMA) or Associate’s degree in Healthcare Administration, Business, or a related field
Additional certifications in medical billing, insurance claims processing, or healthcare administration are advantageous
Preferred: 2+ years of inside sales, referral management, or lead conversion experience within healthcare
Experience working in DME, medical device, or healthcare customer service, preferably supporting urology, ostomy, or chronic care patient populations
Clinical experience as a Medical Assistant, CAN, or similar role preferred; urology or continence care exposure is highly desirable
Knowledge of medical terminology, especially urology-related coding, diagnoses, and product categories is a plus

Responsibilities

Reviews prescriptions, certificates of medical necessity, and supporting clinical documentation to ensure full compliance with payer guidelines, DME requirements, and regulatory standards.
Validates diagnosis codes, product categories (e.g., catheters, drainage supplies), and utilization justification for accuracy and completeness.
Maintains a thorough understanding of urology-related billing protocols, medical necessity criteria, and insurance verification processes.
Engages with patients, caregivers, clinicians, and referral partners with empathy and professionalism to facilitate a seamless ordering experience.
Educates patients on product availability, financial responsibility, recurring shipment schedules, and documentation requirements in a clear and supportive manner.
Addresses and resolves product-related or service-related inquiries, ensuring timely escalation when necessary.
Partners closely with Sales, Clinical Education, Billing, and Supply Chain teams to streamline order flow, resolve discrepancies, and ensure alignment with urology product standards.
Communicates proactively with external referral sources (urologists, nurse practitioners, home health agencies) to obtain missing or corrected documentation.
Serves as the internal advocate for the patient and customer, ensuring efficient problem resolution and continuity of care.
Enters, modifies and tracks patient orders received via phone, email, fax, EDI, or other channels, accurately and efficiently.
Ensures orders comply with insurance coverage guidelines, medical necessity standards, and internal quality protocols.
Monitors order progress, updates stakeholders, and ensures timely fulfillment to prevent disruptions in essential urology supply usage.
Reviews all incoming leads, assess eligibility, and convert qualified leads into compliant and billable orders.
Maintains a structured follow-up cadence to maximize conversion rates and ensures no lapse in patient care or revenue opportunity.
Partners with internal teams to support patient retention, reorder patterns, and long-term utilization of urology solutions.
Maintains accurate and complete records of documentation requests, order statuses, complaint resolutions, and communication touchpoints.
Produces routine reports to management on order accuracy, lead conversion metrics, complaint trends, and overall service performance.
Adheres to HIPAA guidelines and internal confidentiality standards at all times.
Complies with company and departmental policies and administrative requirements.
Performs other duties as assigned or as needed.