Customer Service Associate

Delta Dental of New Jersey • Parsippany-Troy Hills, NJ

just now • $24 • Hybrid

About The Position

A Customer Service Agent following established company guidelines resolves customer issues received by telephone, mail or fax from group administrators, subscribers and dentists.  An Agent explains Delta Dental 's group contracts, agreements, processing policies and procedures.  An Agent can also adjudicate dental claims and resolve adjustments.

Requirements

• 1-3 years customer service or call center experience
• Requires a high school diploma or equivalent; a bachelor's degree is a plus.
• Ability to regard customer service excellence as a priority
• Personal computer skills with knowledge of MS applications such as Windows, Word and Excel and browser based applications such as Internet Explorer
• Excellent communication and listening skills
• Excellent math aptitude
• Creativity and flexibility when solving problems
• Ability to work in an environment where work is carefully monitored for accuracy
• Ability to sit and perform extensive close keyboard and PC work including data entry
• Ability to walk, talk, and hear
• Ability to meet attendance standards.
• Must be able to sit/stand, talk and hear.
• This classification will be required to sign a confidentiality agreement.

Nice To Haves

• Dental Assistant education/experience is a plus
• Occasionally required to stand and reach with hands and arms

Responsibilities

• Adhering to the Agent’s schedule, the Agent is required to be available on the call center ACD to answer customer calls while meeting and exceeding department KPI’s.
• As a team member, researches and resolves inquiries and responds to customers with an appropriate and accurate written or verbal notification.
• Calculates adjustments and creates and processes claims for adjusted payments.
• Creates and processes standard claims, claims with coordination of benefits, pre-treatment estimates, and pretreatment estimates with dated services.
• Maintains and updates subscriber files with information obtained through inquiries and submitted claims and documents, i.e., individual and family on hold codes, applied or removed.
• Performs all tasks necessary to resolve all questions based on Delta Dental’s claims processing guidelines and Dentist handbook, as well as Delta Dental’s website and mobile application.
• Documents each inbound call in call tracking, follow up, or any pended requests.
• Generates check research requests for outstanding payments.
• Understands all claim guidelines and effectively uses this information to resolve related inquiries.
• Researches and resolves requests from other departments such as Marketing and Enrollment.
• When necessary, refers claims or subscriber eligibility to Management or other departments such as Professional Services, Claims, Marketing and Enrollment.
• Supports and participates as needed for inventory reduction tasks such as correspondence and/or call tracking.
• Other duties as assigned

Benefits

• medical, RX, dental and vision, life insurance, short and long term disability, spending accounts, and matching 401k
• learning and development, recognition programs, active wellness and diversity initiatives, tuition reimbursement, and generous paid time off to recharge –  even paid time off to volunteer at causes that you care about

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 101-250 employees