Dental Customer Service Representative
Dental Customer Service Representative
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Job Description
Lets do great things together!
About Moda
Founded in Oregon in 1955 Moda is proud to be a company of real people committed to quality. Today like then were 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 values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Lets be better together.
Job Summary:
This position provides customer service to members of multiple benefit plans by analyzing the callers needs and by providing timely and accurate responses. Answer calls from policyholders agents members providers and others regarding benefits eligibility claims premiums or other issues. This is a fulltime WFH position.
Pay Range
$18.03 $20.18 DOE.
**Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.
Position starts May 5 2025.
Starting Salary: $18/hr
Please fill out an application on our company page linked below to be considered for this position:
Dental Vision Pharmacy Life & Disability
Schedule:
- Monday Friday
- Full time minimum7.5 work days with 37.5 work weeks
Requirements:
- High school diploma or equivalent.
- Practical knowledge of medical or dental terminology preferred but not required.
- Knowledge of diagnosis and procedure coding preferred but not required.
- Prior customer service experience other related experience such as medical/dental office experience or customer support experience.
- Strong reading verbal and written communication skills. Ability to interact professionally patiently and courteously with customers over the phone.
- Good analytical problem solving and decisionmaking skills.
- Type a minimum of 25 wpm net on computer keyboard.
- High speed internet (cable or fiber)
- Must be proficient with Microsoft Office applications with the ability to open and navigate multiple windows at the same time.
- Ability to achieve and maintain quality standards.
- Ability to work well and independently under pressure in a complex and rapidly changing environment.
- Ability to meet the attendance and punctuality policy of Moda Health.
- Ability to remain focused and on task in a work from home environment.
- Maintain confidentiality and project a professional business presence and appearance.
- Ability to repeatedly analyze situations and communicate effectively in a fastpaced environment that includes dealing with escalating queries and concerns.
- Ability to organize and remain up to date on changing and new information.
- Ability to troubleshoot and follow protocols for reporting internet or technological issues.
Primary Functions:
- Answer a high volume of inbound phone calls regarding dental claims benefits premiums and eligibility involving employer groups Oregon Health Plan (OHP) 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 and premium amounts for Individual plans.
- Exercise judgement initiative and discretion in confidential and sensitive matters.
- Perform related duties:
- Follow HIPAA guidelines to protect member health information.
- Document all aspects of a call in a clear and concise manner.
- Keep up to date on new and revised benefit information claim processing procedures or system updates.
- Gather banking details so monthly premium for members on Individual plans can be collected.
- Identify and request claim adjustments when necessary.
- Resolve and record complaints appeals and inquiries.
- Contact providers other insurance companies or state agencies when necessary to answer questions and obtain or provide information.
- Provide timely followup and return calls within department guidelines.
- Answer calls within service level time.
- Perform other duties as assigned by Manager/Supervisor/Lead.
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. This is applicable to all terms and conditions of employment including recruiting hiring placement promotion termination layoff recall transfer leaves of absences compensation and training.
For more information regarding accommodations please direct your questions to Kristy Nehler & Danielle Baker via email.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
