[Remote] Remote Healthcare Customer Service Representative

Note: The job is a remote job and is open to candidates in USA. Conduent is a company that delivers mission-critical services and solutions for Fortune 100 companies and governments. They are seeking a Remote Healthcare Customer Service Representative to assist with healthcare-related calls, providing support and solutions to customers regarding dental benefits and eligibility.

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

Skills

• Successfully complete customer service assessment & typing test
• High school diploma, GED, or college degree
• At least 1 year of Call Center experience preferred
• 1 year of face-to-face customer service experience
• Knowledge of and prior experience in the Dental, Medical or Managed Care industry is preferred
• 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
• Must have a home internet connection of 10 Download and 3 Upload Speed
• Must be able to hardwire your work computer directly to your home modem via ethernet
• Must have a distraction free and secure work environment
• 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

Company Overview