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Dental Customer Service

2 months ago

Worcester, United States The Nagler Group Full time

Hybrid - Worcester 3 days onsite 2 from home

Up to $55K


Key responsibilities and accountabilities:


  • Respond to inbound telephone calls, faxes and emails from doctors or doctor’s office staff, and plan sponsor representatives in a timely and professional manner;
  • Respond to inbound telephone calls, faxes and emails from members or member representatives in a timely and professional manner;
  • Process dental claims on system for all clients;
  • Process claim corrections from daily EDI reports;
  • Document communications with doctors and doctor’s office staff, and plan sponsor/employer representatives;
  • Document communications with members and member representatives;
  • Respond to claim inquiries from subscribers, doctors and plan sponsor/employer representatives in a timely and professional manner;
  • Respond to benefit coverage inquiries from members and member representatives in a timely and professional manner;
  • Respond to eligibility inquiries from subscribers, doctors and plan sponsor/employer representatives in a timely and professional manner;
  • Maintain department productivity and quality expectations;
  • Maintain knowledge of dental plan designs, exclusions, limitations and exceptions for each client;
  • Adhere to all process and procedural guidelines;
  • Any other duties as assigned