Dental Customer Care-Claims Specialist

Medical Mutual•Dayton, OH

4d•Remote

About The Position

Medical Mutual is hiring for Dental Customer Care-Claims Specialist I and II roles within its dental claims and customer care department. Both are blended positions that handle customer inquiries and process dental claims. Specialist I works under direct supervision, answering inbound calls and processing routine claims. Specialist II works under limited supervision, handling inbound calls and written inquiries across multiple channels and processing routine to moderately complex claims and adjustments. Specialist II may also conduct claims- or inquiry-related research under the direction of more senior staff and assist with management-directed projects. The position is remote, with an expectation to work onsite in Centerville, Ohio, once per quarter. Medical Mutual provides equipment for the role, including a laptop, monitors, keyboard, mouse, and headset.

Requirements

Associate’s degree in business or healthcare administration, communications, or a related field; equivalent education and directly related experience may substitute.
Specialist I: 1 year of customer service and/or claims experience.
Specialist II: 2 years of experience as a Customer Care/Claims Specialist or equivalent customer service experience.
Basic Microsoft Office skills for Specialist I; basic to intermediate Microsoft Office skills for Specialist II.
Knowledge of standard customer service best practices and principles.
Knowledge of the Health Insurance Portability and Accountability Act (HIPAA).

Nice To Haves

Customer service or claims experience in a call center in the health or dental insurance industry, or in a dental provider’s office.
For Specialist II, customer service experience preferably in dental insurance, a dental provider’s office, or the healthcare/health insurance industry.
Certified Dental Billing Specialist (CDBS), Certified Dental Coder (CDC), or Certified Dental Assistant (CDA).
Basic knowledge of dental benefits, services, terminology, and American Dental Association coding for Specialist I.
Solid knowledge of dental benefits, services, terminology, and American Dental Association coding for Specialist II.

Responsibilities

Use multiple systems, applications, and reference tools.
Provide customer service to members, providers, clients, employers, and brokers through inbound call queues.
Process routine dental claims in accordance with performance expectations, service philosophy, and service level agreements.
For Specialist II, respond to written inquiries through channels such as email, chat, and portal inquiries.
For Specialist II, process routine to moderately complex dental claims and adjustments.
For Specialist II, conduct dental claims- or inquiry-related research under the direction of more senior staff.
For Specialist II, assist with projects as directed by management.
Perform other duties as assigned.

Benefits

Employee bonus program.
401(k) with company match up to 4% and an additional company contribution.
Health Savings Account with a company matching contribution.
Medical, dental, vision, life, and disability insurance.
Employee Assistance Program with counseling, coaching, self-help resources, and work/life benefits assistance.
Company holidays and up to 16 PTO days during the first year, with options to carry over unused PTO.
Parental leave after 120 days of service for eligible employees who become parents through maternity, paternity, or adoption.
Career development programs and classes.
Mentoring and coaching.
Tuition reimbursement up to $5,250 per year.
Access to on-site fitness centers at many locations or gym membership reimbursement where a Medical Mutual facility is unavailable.
On-site cafeteria at the Brooklyn, Ohio headquarters.
Employee discounts at participating local businesses.
Opportunity to earn cash rewards for shopping with Medical Mutual customers.
Business casual attire, including jeans.