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Remote Healthcare Customer Service Representative
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.
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.
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.
Benefits
- Medical, dental and vision benefits are available on the 1st day of employment.
- Paid time off is accrued after 180 days (about 6 months) of employment.
- health insurance coverage
- voluntary dental and vision programs
- life and disability insurance
- a retirement savings plan
- paid holidays
- paid time off (PTO) or vacation and/or sick time.
