Customer Experience Representative

2 months ago

Naperville, United States Delta Dental Full time
Job Details

Level
Experienced

Job Location
Delta Dental of Illinois - Naperville, IL

Position Type
Full Time

Education Level
High School

Travel Percentage
None

Job Shift
Day

Job Category
Customer Service

Description

We are the largest dental insurance company and continue to grow. Based in Naperville, IL Delta Dental of Illinois has over 50 years of oral health experience and is dedicated to clients and employees alike.

Our company culture is diverse, innovative and focused on achieving our goals.

We believe in improving oral health through our dental benefit programs and through our Foundation, which develops and supports projects and organizations that improve access to oral care and oral health education.

OVERVIEW OF POSITION: The Customer Experience Representative is responsible for providing service to the
DDIL client base through effective verbal and written communication as well as troubleshooting and resolving
all types of dental claim related inquiries.

DUTIES & RESPONSIBILITIES:
•Understanding of dental terminology.
•Ability to use good judgment when applying dental knowledge when processing claims and handling client
calls.
•Accurately respond to verbal and written inquiries and complaints directly from subscribers, providers,
brokers, or group administrators.
•Accurately process claim adjustments during the phone call and/or during regular work time.
•Review and process claims according to established business rules that have failed computer program edits.
•Maintain and follow up on documents for all adjustment requests, check investigations, overpayment
letters and e-forms.
•Complete and maintain daily log/forms/reports.
•Assist in new representatives' training.
•Accurately completes special projects assigned within specified time frames.
•Continued training in calls and claims with further progression based upon meeting performance
requirements.
•Accesses EPHI following the current guidelines as established at the company- wide and department levels.
•Maintains regular attendance and punctuality.
•Performs other job-related duties as assigned.
•Ability to provide feedback to CS leadership or team members in order to contribute to one common goal.

Qualifications

The ideal candidate will have:
•Strong customer service skills.
•Excellent oral and written communications skills.
•Strong computer keyboard skills and capable of working in an ACD environment with talk and work time
goals.
•Knowledge of insurance reimbursement practices, i.e. processing policies, deductibles, maximums,
Coordination of Benefits (COB) and dental terminology.
•Ability to work independently and execute multiple tasks simultaneously
•Excellent attendance and punctuality record.
•Strong organization skills and attention to detail.
•High School Diploma or Equivalent.

While not a requirement for the position, a preference is given to those who:
•Speak Spanish fluently
•Ability to review dental photos and x-rays and make diagnostic determinations based on provider claim
narratives.

Why Should You Apply?
  • We offer free dental for employees and their dependents/free vision, life, STD/LTD for employees/medical options for many budgets/401k and company match.
  • Generous PTO program; 11 paid holidays
  • Great people
  • Competitive benefits
  • Healthy work/life balance
  • We are conveniently located off of I-88

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