Member Services Representative

Willamette Dental•Hillsboro, OR

13d•Onsite

About The Position

The Member Services Representative communicates with members via incoming calls to efficiently and effectively answer membership questions regarding benefit eligibility, performs outreach communications and handles all inquiries within the scope of the position’s responsibility.

Requirements

High School Diploma or equivalent and two years of customer service experience in a high volume call center; or any equivalent combination of education and/or experience which leads to the ability to perform the essential functions of the position.
Experience in communicating benefits to members with diverse backgrounds and cultures preferred.

Responsibilities

Respond to Member calls in a courteous and professional manner, answering questions and inquiries regarding membership eligibility, benefits, claims, notice of actions or adverse benefit determinations, grievance processes, policies and procedures.
Completes forms and other paperwork as needed, and document all incoming and outgoing calls.
Educate members on the guidelines of their dental benefits with the company and their insurance partners.
Understand and clearly communicate Willamette Dental Group systems, processes, policies and treatment services to members.
Assess and resolve problems within the scope of authority; escalates complex questions or problems to more experienced representatives or higher authority level.
Identify complaints and understand how to facilitate the process with the Practice or Member Services Grievance, Appeal and Care Coordination.
Supports various outreach programs