Customer Service Representative – Remote Jobs

Job Type: Dental Customer Service Representative from home
Location: Boston work from home
Company: Moda Health

In order to deliver prompt and correct responses to customers of numerous benefit plans, this job analyzes the demands of the caller. Respond to inquiries about benefits, eligibility, claims, premiums, and other matters from policyholders, agents, members, providers, and others.

Beginning Pay: $18.03 per hour

Advantages:

• Health, Dentistry, Optometry, Pharmacy, Life, and Disability
• Schedule of Company Paid Holidays, PTO, and FSA Employee Assistance Program in addition to 401K Matching
• Monday through Friday
• 7.5 full-time days and 37.5 work weeks are required.

Requirements:

• A high school diploma or its equivalent.
• Although not necessary, practical understanding of dental or medical terminology is preferred.
• Although not necessary, familiarity with diagnosis and procedure coding is preferred.
• Experience in a medical or dental office, previous customer service experience, or customer support experience are examples of relevant experiences.
• strong communication skills—both written and verbal—in reading. Ability to communicate with consumers over the phone in a polite, professional, and patient manner.
• strong analytical, decision-making, and problem-solving abilities.
• At a minimum, use the computer keyboard to type at 25 wpm net.
• high-speed fiber or cable internet
• Proficiency in Microsoft Office products is required, as well as the ability to open and manage numerous windows simultaneously.
• the capacity to meet and uphold quality standards.
• Capacity to function proficiently and autonomously in a demanding and swiftly evolving setting.
• Capacity to adhere to Moda Health’s attendance and punctuality policies.
• the capacity to stay concentrated and on task when working from home.
• Uphold confidentiality and present a polished image for your company.
• The capacity to consistently assess circumstances and interact with others in a fast-paced setting while handling increasing levels of questions and worries.
• the capacity to stay organized and informed about new and evolving knowledge.
• the capacity to diagnose and adhere to procedures when reporting technical or internet problems.

Responsibilities:

• Respond to a large number of incoming questions about eligibility, workplace groups, Oregon Health Plan (OHP), and individual products, as well as dental claims, benefits, and premiums. Solve issues, verify eligibility, and clarify benefits and/or plan coverage.
• Give precise information while acting professionally.
• Use your mathematical knowledge to calculate the correct premium amounts and benefit details for individual plans.
• When dealing with delicate and private problems, use caution, initiative, and judgment.
• Carry out associated tasks:
• To safeguard member health information, abide by HIPAA regulations.
• Make sure to clearly and succinctly record every facet of the conversation.
• Stay informed about any updates to the system, new and altered benefit information, or claim processing guidelines.
• Obtain banking information in order to collect the monthly premium from subscribers of individual plans.
• Determine what adjustments are needed, then ask for them.
• Address and document grievances, appeals, and questions.
• When it comes to answering inquiries and obtaining or providing information, get in touch with providers, other insurance firms, or state agencies.
• Follow up promptly and return calls in accordance with departmental policies.
• Return calls within the allotted service time.
• Execute additional tasks as directed by the manager, supervisor, or lead.

Without regard to a person’s race, religion, color, age, sex, sexual orientation, national origin, marital status, handicap, veteran status, or any other legally protected status, Moda Health aims to provide equal employment opportunities to all qualified applicants.

Pay Range: $18.03 per hour to $22.32 per hour