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Moda Health Dental Customer Service Representative in Milwaukie, Oregon

Dental Customer Service Representative

Job Title

Dental Customer Service Representative

Duration

Training Starts Tues. Jan 21, 2020

Location

Milwaukie,

OR

97222

Other Location

Job Class: 106.6; Bend, Oregon and Anchorage, AK

Description

Let’s do great things, together Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together.Moda Health is searching for Customer Service Reps who will provide customer service to our dental members of multiple benefit plans by analyzing the caller’s needs and by providing timely and accurate responses and answer calls from policyholders, agents, members, providers, hospitals, pharmacists and others regarding benefits or other issues.Primary Functions:

  • Answer claim benefit questions from callers on both group and individual products. Provide solutions to problems, confirm eligibility, explain benefits and/or plan coverage.

  • Provide accurate information in a professional manner.

  • Apply mathematical skills to determine correct benefit information.

  • Exercise judgment, initiative, and discretion in confidential and sensitive matters.

  • Perform related duties:

  • Review, update and become familiar with new and revised benefit information or claim processing procedures.

  • Update and enter primary care physician selections and coordinate with Group Integration.

  • Request claim adjustments required because of error or new information.

  • Resolve and record complaints, appeals, and inquiries.

  • Provide customer service to walk-in members.

  • Contact physicians, dentists, hospitals, and other providers when necessary to answer questions and obtain or provide information.

  • Provide timely follow-up and return calls when these are required.

  • Answer calls within service level time.

  • Perform other related duties as assigned.

Are you ready to be a betterist? If you’re ready to make a difference that matters, we want to hear from you. Because it’s time to discover what’s possible. Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law.

Required Skills

  1. High school diploma or equivalent.

  2. Practical knowledge of medical or dental terminology desired.

  3. Knowledge of diagnosis and procedure coding desired.

  4. Claim processing experience or prior customer service experience or other related experience such as medical/dental office experience.

  5. Excellent oral and written communication skills Ability to interact professionally, patiently, and courteously with customers over the phone and in person.

  6. Good analytical, problem solving and decision-making skills.

  7. 10-key proficiency of 105 kspm net on a computer numeric keypad.

  8. Type a minimum of 25 wpm net on computer keyboard.

  9. Ability to work well under pressure in a complex and rapidly changing environment.

  10. Ability to come into work on time and on a daily basis.

  11. Maintain confidentiality and project a professional business presence and appearance.

  12. Ability to repeatedly analyze situations and communicate effectively in a fast paced environment that includes dealing with angry people.

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