Job Description

Job Description

Job Description

Job Summary: The Customer Service Representative in the Dental Benefit Department is responsible for providing exceptional customer service to members, providers, brokers, and group administrators. This role involves handling incoming calls, verifying eligibility, explaining benefits, researching claim payments, and answering general inquiries while working remotely from home.

Key Responsibilities:

• Handle incoming calls from members, providers, brokers, and group administrators.
• Verify eligibility and benefits for dental services.
• Explain Explanation of Benefits (EOB) statements to members.
• Research and resolve claim payment issues.
• Provide accurate information regarding dental benefits and coverage.
• Assist members with understanding their dental plan options and coverage details.
• Document all interactions and maintain accurate records in the customer service database.
• Collaborate with other departments to resolve complex issues and ensure member satisfaction.
• Stay updated on changes to dental benefit plans and policies.
• Participate in training sessions and team meetings to stay informed about department updates and best practices.

Qualifications:

• High school diploma or equivalent; some college coursework preferred.
• Previous experience in a customer service role, preferably in a healthcare or dental benefits environment.
• Strong communication skills, both verbal and written.
• Excellent problem-solving and analytical skills.
• Ability to handle high call volumes and work in a fast-paced environment.
• Proficiency in using customer service software and databases.
• Knowledge of dental terminology and benefit plans is a plus.
• Ability to work independently and as part of a team.
• Strong attention to detail and organizational skills.

Working Conditions:

• This position is primarily remote work from home.
• Standard working hours with occasional overtime as needed, 9am – 5pm Eastern, Monday through Friday.

Benefits:

• Competitive salary and benefits package.
• Health, dental, vision insurance, and life insurance.
• Paid time off and holidays.
• Retirement savings plan.
• Opportunities for professional development and career advancement.

Daniel H. Cook Associates Inc, is a TPA centrally located in Midtown Manhattan.
More info on the company can be found at

Company Description

Daniel H. Cook Associates Inc, is a TPA centrally located in Midtown Manhattan.\r\nMore info on the company can be found at

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