Remote Healthcare Customer Service Representative

Conduent•Remote, KY

6d•Remote

About The Position

Would you enjoy being part of a team that makes a difference in people’s lives? Do you love helping people solve complex problems and deliver solutions? We are looking for people with a passion for helping others, natural empathy, and who are determined to deliver a comprehensive solution to healthcare-related calls. To be successful, customer service experience is a plus, but not a requirement. Conduent has plenty of growth opportunities within the healthcare team.

Requirements

Successfully complete customer service assessment & typing test.
High school diploma, GED, or college degree
1 year of face-to-face customer service experience.
Must possess the following characteristics: self-motivation, resourceful, detail-oriented, sense of accountability and must be a team player.
Must possess strong skills in the following areas: organizational, time management, written and verbal communication, analytical, and problem solving.
Proficiency in Microsoft Word, Microsoft Outlook, and Internet Explorer.
Effective communication skills over the phone.
Ability to deal with problems involving several concrete variables in standardized situations.
Successful completion of background check is required for this position.

Nice To Haves

At least 1 year of Call Center experience preferred.
Knowledge of and prior experience in the Dental, Medical or Managed Care industry is preferred.

Responsibilities

Respond to inbound inquiries regarding dental benefits, eligibility, claims, appeals, grievances, and provider searches for both Commercial and Medicare plans.
Provide uniform interpretation and clarification of dental benefits, policies, and procedures to members, providers, and employer groups.
Actively attempt to resolve member or provider concerns by investigating issues, contacting appropriate parties, and documenting all interactions accurately within the billing system.
Investigate verbal complaints regarding billing, claims, or services rendered; escalate service failures to appropriate internal departments for follow-up and resolution.
Retrieve and send written correspondence, including plan brochures, provider directories, and other printed materials as needed.
Meet or exceed established ACD (Automated Call Distribution) system call volume and quality performance goals.
Achieve all assigned individual monthly performance metrics.
Maintain current and thorough knowledge of all Member Services policies, procedures, and dental plan updates.
Perform additional duties and responsibilities as assigned by management.