Dental Customer Care-Claims Specialist

Medical Mutual•Cleveland, OH

3d•Remote

About The Position

Medical Mutual is hiring for Dental Customer Care-Claims Specialist I and II roles in its dental claims and customer care department. These blended positions handle inbound calls from members, providers, clients, employers, and brokers while processing dental claims. Specialist I works under direct supervision and handles routine claims. Specialist II works under limited supervision and handles calls and written inquiries across multiple channels, routine to moderately complex claims and adjustments, and research under the direction of more senior staff. The role is remote, with an expectation to work onsite in Brooklyn, Ohio, once per quarter. Medical Mutual provides the equipment needed for the role, including a laptop, monitors, keyboard, mouse, and headset.

Requirements

Specialist I: Associate’s degree in business or healthcare administration, communications, or a related field; equivalent directly related education and experience may substitute.
Specialist I: One year of customer service and/or claims experience, preferably in a health or dental insurance call center or a dental provider’s office.
Specialist I: Basic Microsoft Office skills.
Specialist I: Basic knowledge of dental benefits, services, terminology, and American Dental Association coding.
Specialist I: Knowledge of standard customer service best practices and principles.
Specialist I: Knowledge of the Health Insurance Portability and Accountability Act (HIPAA).
Specialist II: Associate’s degree in business or healthcare administration, communications, or a related field; equivalent directly related education and experience may substitute.
Specialist II: Two years of experience as a Customer Care/Claims Specialist or equivalent customer service experience, preferably in dental insurance, a dental provider’s office, or the healthcare/health insurance industry.
Specialist II: Basic to intermediate Microsoft Office skills.
Specialist II: Solid knowledge of dental benefits, services, terminology, and American Dental Association coding.
Specialist II: Knowledge of standard customer service best practices and principles.
Specialist II: Knowledge of the Health Insurance Portability and Accountability Act (HIPAA).

Nice To Haves

Certified Dental Billing Specialist (CDBS), Certified Dental Coder (CDC), or Certified Dental Assistant (CDA) certification.

Responsibilities

Use multiple systems, applications, and reference tools to provide customer service through inbound call queues while processing dental claims.
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 professional counseling, personal and professional 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 for eligible employees after 120 days of service, including maternity, paternity, or adoption leave.
Career development programs and classes.
Mentoring and coaching.
Tuition reimbursement up to $5,250 per year.
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.
Access to diverse and inclusive Business Resource Groups.