Responds to questions from prospective and existing members, groups, partners and dental offices regarding products and plans. Requires resolution of problems with claims/transactions, complaints and appeals with dentists, and group enrollment. Provides online and email support by responding to service, technical and financial question. Troubleshoots and provides resolution by delivering consultative support to questions. Works with a wide variety of internal resources to resolve issues to ensure customer satisfaction.
• Responds to current and prospective customer questions and complaints/appeals in a timely and empathetic manner via telephone or web inquiries
• Researches complaints, appeals, claims, processing issues, benefit and eligibility requests and all communication with external and internal customers
• Collaborates with Operations to review claims and decisions regarding payment
• Answers inquiries from dental offices to clarify coverage levels, identify allowable procedures, and resolve claims payment issues
• Builds a strong rapport with dental office staff, groups and members to ensure a positive perception of the company within the community
• Support outbound phone or messaging campaigns that support consumer and provider engagement
• Other duties as assigned
Qualifications: (Education/Experience/Skills Required)
• High school diploma or equivalent, college degree preferred
• Previous customer contact experience (i.e. customer call center, dental office experience, or experience within a similar insurance system)
• Dental office, clinical assistant or insurance necessary
• Excellent communication skills (verbal and written)
• Attention to detail and accuracy essential
Bi-Lingual position, Spanish preferred
Delta Dental of Rhode Island is the state’s leading dental insurer, administering dental benefits for nearly 613,000 members. Headquartered in Providence, we remain a symbol of strength and stability in the local dental insurance arena.
Our strength is evidenced by the fact that 96% of our customers said they were satisfied or very satisfied with our overall performance last year. And, 98% said they were satisfied with the quality of their treatment.
For more than 50 years, Delta Dental has provided affordable dental insurance to employers, individuals and families across the country. As the nation’s largest, most experienced dental benefits carrier, Delta Dental serves more than 73 million Americans with dental coverage. Delta Dental provides dental coverage to more than 139,000 groups nationwide.