Spanish Bilingual

Offer: 50,000 to 60,000 plus benefits and incentives

• Requires a high school diploma or equivalent.
• Prior dental office experience and/or dental medical insurance experience is a plus.

• Proficient computer skills and data entry skills.
• Comfortable with current technology with ability to navigate multiple screens, use Teams and/or Zoom, etc.
• Solid customer service, problem solving, and conflict resolution skills.

• Responsible for responding to a high volume of inbound calls from dental offices (dentists and office staff), members, group administrators, etc.
• Interfaces and communicates with internal customers such as Group Administration, Individual Administration, Electronic Eligibility, Client Services, etc.
• Effectively and patiently listens to questions and concerns provided to them and responds in a timely and accurate manner.
• Adheres to call audit guidelines and principles and achieves operational expectations specific to Availability, Call Quality with emphasis on Average Call Handle Time and other defined individual and departmental metrics.
• Documents and maintains systematic records of calls, documenting them clearly and concisely to ensure effective interpretation by any internal team member.
• Escalates calls as appropriate following internal guidelines and processes.
• Responsible for researching issues in order to respond appropriately and accurately to claims related questions.
• Accountable for following all Federal, State, Compliance and HIPAA guidelines.

A.1 Position Title: Provider Call Representative

• Requires a high school diploma or equivalent.
• Dental office experience and/or dental medical insurance experience is a plus

• Proficient computer skills and data entry skills.
• Comfortable with current technology with ability to navigate multiple screens, use Teams and/or Zoom, etc.
• Solid customer service, problem solving, and conflict resolution skills.
• Research skills and attention to detail.
• Advanced written and verbal communication skills with the ability to effectively communicate and interact with all levels of personnel and members.

• Responsible for responding to a high volume of inbound calls from dental offices (dentists and office staff), members, group administrators, etc.
• Interfaces and communicates with internal customers such as Group Administration, Individual Administration, Electronic Eligibility, Client Services, etc.
• Effectively and patiently listens to questions and concerns provided to them and responds in a timely and accurate manner.
• Adheres to call audit guidelines and principles and achieves operational expectations specific to Availability, Call Quality with emphasis on Average Call Handle Time and other defined individual and departmental metrics.
• Documents and maintains systematic records of calls, documenting them clearly and concisely to ensure effective interpretation by any internal team member.
• Escalates calls as appropriate following internal guidelines and processes.
• Responsible for researching issues in order to respond appropriately and accurately to claims related questions.
• Accountable for following all Federal, State, Compliance and HIPAA guidelines.
• May be called upon to assist other departments on a short term (30-60 days) basis.
• Other duties and projects as requested/assigned.

• This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, and phones, and photocopiers.
• Ability to perform the essential functions of the job with or without a reasonable accommodation.
• No physical effort beyond that is typically required in a normal office environment.
• Regular exposure to a computer screen.