- Responds to basic telephone, electronic and written in from dental or vision professionals, groups, subscribers and brokers or customers
- Expediently accesses reference materials to analyze and determine appropriate response to telephone, electronic and written inquiries
- Communicates basic eligibility, benefits and claims status and forward specific inquiries as directed for priority resolution
- Accurately completes online, hard copy forms and route to the appropriate department
- Documents each customer encounter or resolution in the appropriate computer tracking system
- Obtains pertinent patient demographics and documents this information in the patient database when required
- Provides information for subscribers such as questions pertaining to insurance, billing, claims or eligibility
- Identifies, reports and documents system discrepancies
- Meets and maintains production standard, counts and inquiry response turnaround
salary: $17.5 - $17.5 per hour
work hours: 8 AM - 5 PM
education: High` School
- Responds to provider calls and correspondences related to instructions on network participation, contract interpretation, contracted fees, resolution of complex claims and service issues, provider communications and provider terminations at point of contact.
- Educates and promotes the various Delta provider networks; drafts content for various collateral materials for distribution to network dentists; advises local Delta Dental member company PR staff on program changes, and quickly identifies trends in service issues and recommends course of action.
- Builds and maintains strong relationships with local Delta Dental member companies to achieve common goals; works to meet the local business needs as well as the Federal Services needs for recruitment and contracting of the PPO network.
- Assists with provider portal sign-on issues and resets passwords when necessary.
- Resolves 1099, EFT and ERA discrepancies with provider offices; verifies external data bases.
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