Customer Service Associate

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