Dental Customer Service Representative – National Remote

Regardless of your role at UMR, the support you feel all around you will enable you to do what you do with energy, quality, and confidence. So, take the first step in what is sure to be a fast – paced and highly diversified career. 

This is a 100% remote position that fields calls from both members and providers and also adjudicate claims (at a later date after completing the claims training for the role). On a typical day, Dental Customer Service Representatives can expect take anywhere from 35-45 calls a day on average mainly from members, but occasionally from providers as well. Their remaining time would be spent processing claims or completing administrative tasks associated with the role. Dental Customer Service Representatives should expect to be on the phone their entire shift, with scheduled breaks and lunches. These representatives use up to 5 different computer systems to provide the information needed to members and providers during their calls, so the ability to multitask and prior experience utilizing multiple systems/platforms while on a call are key to success in the role. 

Even if you have no prior experience, we have training classes starting soon to help you build the successful career that you want – apply today! We provide the support and structure, you provide the interest and motivation. 

You like working with people. Even more so, you like helping them. This is your chance to join a team dedicated to helping our members and their families every day. In this joint role as a Dental Customer Service Representative, you’ll join us on a mission to not only deliver the best customer service in the health care industry, but the best customer service. Period. Your compassion and customer service expertise combined with our support, training and development will ensure your success. This is no small opportunity. This is where you can bring your compassion for others while doing your life’s best work.^SM 

In this role, you play a critical role in creating a quality experience for the callers that you connect with and those that you correspond with. Every interaction gives you that opportunity to improve the lives of our customers and exceed their expectations. You’ll spend the majority of your day by responding to calls from our members and help answer questions and resolve issues regarding health care eligibility, claims and payments. You’ll also spend a portion of your time reviewing, researching and processing healthcare claims with the goal to ensure that every claim has a fair and thorough review. 

This position is full-time (40 hours/week) Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00am – 7:00pm CST. It may be necessary, given the business need, to work occasional overtime. 

We offer 5 weeks classroom based, 2 weeks of on-the-job training. Additional on-the-job training once assigned to their shift with the Dental team.  The hours during training will be 8:00am to 4:30pm CST, Monday – Friday. Training will be conducted virtually from your home.  

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.  

Primary Responsibilities: 

• Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs) 
• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems  
• Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member 
• Review and research incoming Dental claims from members and providers (Dentists, Dental clinics, etc) by navigating multiple computer systems and platforms and verifies the data/information necessary for processing (e.g. pricing, prior authorizations, applicable benefits) 
• Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates) 
• Communicate and collaborate with members and providers to resolve issues, using clear, simple language to ensure understanding 
• Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, member satisfaction and attendance 

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.