Customer Service - Work at Home

ibex is hiring Customer Service Representatives to support customers with inquiries and requests related to products and services across multiple lines of business. The role focuses on healthcare and dental coverage, claims, benefits, authorizations, and access to care through multiple customer contact channels.

Responsibilities:

• Resolving coordination of benefits inquires by analyzing patient activity (including enrollment, third party liability, claims attachments)
• Having a comprehensive understanding of insurance coverage and being able to interpret and communicate accurate information
• Thoroughly and completely documenting all customer interactions
• Educating customers and dental professionals on eligibility, benefits, claims payment, and authorizations
• Educating on the usage and benefits of self-service tools
• Assisting members on gaining access to care by locating a network dentist or assignment to a primary care dentist
• Directing inquires to necessary departments or individuals when the resolution of the inquiry is beyond the span of control for this role
• Responding to customer inquiries in a courteous and professional manner
• Researching and consistently providing accurate information to resolve all member and provider inquiries through verbal and written communications through all channels including phone, email, web portal, and chat interactions
• Responding to and resolving internal and external complex customer inquiries
• Resolving claim payment inquiries by researching and analyzing patient activity and determining appropriate action to be taken
• Taking ownership of the resolution and setting expectation for follow up
• Ensuring resubmissions, stop payments, and voids are appropriately handled
• Meeting or exceeding individual, department, and client specific goals
• Understanding and adhering to all client administrative and contractual policies and procedures
• Suggesting ways to improve the service delivery processes contributing to the success of the organization
• Other duties as assigned

Requirements:

• Experience in healthcare or related industry experience
• Medical/Dental terminology knowledge experience
• Medicare/Medicaid knowledge
• Claims/Billing and coding experience