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Government Programs Customer Service Representative

Delta Dental • Okemos, MI • 4h ago

Location:

Farmington Hills, MI

Location Specifics:

Fully Remote

Job Summary:

**Candidates must reside within a reasonable commuting distance of our Farmington Hills office for team meetings, collaborative sessions, and training.

Training will be hybrid.**

At Delta Dental of Michigan, Ohio, and Indiana we work to improve oral health through benefit plans, advocacy and community support, and we amplify this mission by investing in initiatives that build healthy, smart, vibrant communities for all. We are one of the largest dental plan administrators in the country, and are part of the Delta Dental Plans Association, which operates two of the largest dental networks in the nation.

At Delta Dental, we celebrate our All In culture. It's a mindset, feeling and attitude we wrap around all that we do -- from taking charge of our careers, to helping colleagues and lending a hand in the community.

Typical Assignments

Promptly and professionally responds to member, client and provider questions through multiple channels, including, but not limited to telephone, email, fax and U.S. mail communication using proper etiquette, grammar, punctuation, etc.

Clearly and accurately communicates all eligibility, benefit, claim status and payment information related to caller's questions

Properly identifies the reason(s) for the call and provides appropriate resolution to inquiries and complaints within specified timeframes and guidelines established by regulatory agencies or client contracts.

Informs and assists callers with grievance and the claims appeals processes, as necessary

Clearly, accurately and thoroughly documents information in the customer relationship management system to ensure all relevant details of the phone call are captured.

Understands the importance of adhering to regulatory requirements

Meets or exceeds quality standards as required for position

Meets or exceeds call center metrics as required for position

Enters and adjusts claims as required

Minimum Requirements:

Bidding Requirements

Employees must have the ability to work an assigned eight (8) hour schedule starting as early as 7:55 a.m. and ending as late as 11:00 p.m., Monday through Friday

Possess a high school diploma or equivalent, with an associate's degree in business administration or a related field preferred

Two years of customer service experience in a business environment that requires the use of a software application to assist customers, preferably in a call center assisting Medicare and/or Medicaid enrollees

Demonstrated knowledge of personal computers and software applications (including Windows) through previous experience and/or coursework

Successful completion of the customer service simulation assessment with a minimum score of 62 out of a possible 100 (assessment waived if candidate previously passed test while at Delta Dental or if previously held Customer Service Trainee, Customer Service Advisor, or Customer Service Associate position)

Successful completion of the customer service multitasking and call logging assessment with a minimum score of 65 out of a possible 100

Successful completion of the customer service email composition assessment with a minimum score of 62 out of a possible 100

The company will provide equal employment and advancement opportunity within the @context of its unique business environment without regard to race, color, religion, gender, gender identity, gender expression,

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