Delta Dental of New Jersey and Connecticut is the state's largest dental coverage provider, serving over 1.7 million people. They are seeking a Customer Service Associate to resolve customer issues, explain group contracts, and adjudicate dental claims.
Responsibilities
- Adhering to the Agent’s schedule, the Agent is required to be available on the call center ACD to answer customer calls while meeting and exceeding department KPI’s
- As a team member, researches and resolves inquiries and responds to customers with an appropriate and accurate written or verbal notification
- Calculates adjustments and creates and processes claims for adjusted payments
- Creates and processes standard claims, claims with coordination of benefits, pre-treatment estimates, and pretreatment estimates with dated services
- Maintains and updates subscriber files with information obtained through inquiries and submitted claims and documents, i.e., individual and family on hold codes, applied or removed
- Performs all tasks necessary to resolve all questions based on Delta Dental’s claims processing guidelines and Dentist handbook, as well as Delta Dental’s website and mobile application
- Documents each inbound call in call tracking, follow up, or any pended requests
- Generates check research requests for outstanding payments
- Understands all claim guidelines and effectively uses this information to resolve related inquiries
- Researches and resolves requests from other departments such as Marketing and Enrollment
- When necessary, refers claims or subscriber eligibility to Management or other departments such as Professional Services, Claims, Marketing and Enrollment
- Supports and participates as needed for inventory reduction tasks such as correspondence and/or call tracking
- Other duties as assigned
Skills
- 1-3 years customer service or call center experience
- Requires a high school diploma or equivalent
- Ability to regard customer service excellence as a priority
- Personal computer skills with knowledge of MS applications such as Windows, Word and Excel and browser based applications such as Internet Explorer
- Excellent communication and listening skills
- Excellent math aptitude
- Creativity and flexibility when solving problems
- Ability to work in an environment where work is carefully monitored for accuracy
- Ability to sit and perform extensive close keyboard and PC work including data entry
- Ability to walk, talk, and hear
- Occasionally required to stand and reach with hands and arms
- Ability to meet attendance standards
- Must be able to sit/stand, talk and hear
- Dental Assistant education/experience is a plus
- A bachelor's degree is a plus
Benefits
- Medical
- RX
- Dental and vision
- Life insurance
- Short and long term disability
- Spending accounts
- Matching 401k
- Learning and development
- Recognition programs
- Active wellness and diversity initiatives
- Tuition reimbursement
- Generous paid time off to recharge
- Paid time off to volunteer at causes that you care about
Company Overview
Delta Dental of New Jersey is a member of the national Delta Dental Plans Association, which serves nearly one-third of the estimated 166 million Americans with dental benefits, providing dental coverage to over 60 million people in nearly 111,000 groups across the nation. It was founded in 1969, and is headquartered in Parsippany, New Jersey, USA, with a workforce of 201-500 employees. Its website is https://www.deltadentalnj.com.
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