Job Description

Job Description

Job Description

About Us.

Delta Dental of NJ, Inc., located in Parsippany, New Jersey is seeking can-do, great communicators and individuals who value providing an exceptional customer experience to work full time in our Call Center. We'll be starting a new group of Customer Service Agents on Monday, October 28th, and our schedule is hybrid, with associates in our freshly renovated office Tuesdays and Wednesdays, and remote Mondays, Thursdays and Fridays. During the first 6 weeks, new Customer Service Agents attend full time, paid training from 9 am to 5:30 pm Monday through Thursday, and 9 am to 5 pm Friday. Training is also hybrid. Following the training program, the regular schedule begins, which is 10:30 to 6:30 Monday through Thursday, and 9 - 5 on Friday.

We offer excellent benefits, including medical, dental, Rx and vision, matching 401k, tuition reimbursement, paid time away, and much more. The hourly starting rate for all Customer Service Agents is $24.29/hour, and all associates are paid weekly.

In addition to having call center experience, we're excited to hire individuals who have some dental insurance experience too.

What You'll be Doing.

Each day, you'll be taking approximately 100 inbound calls from our members/subscribers, dental providers and others and responding to their question related to benefit coverage and claims questions. You'll wear a headset, and calls will come into your headset directly from our Automatic Call Distributor (ACD). You'll be responsible for handling each call with the utmost professionalism, care, and your ability to resolve the concerns of the callers you're working with. We'll schedule your lunch and breaks based on our forecasted call volume, and expect you to adhere to the schedule so we can respond promptly to our customers and minimize how long they're waiting to connect with us.

What's Next?

If you have call center experience, or have related skills that can easily transfer to the responsibilities of our Call Center Agent, apply today! We review all applications that we receive!

For a full description of the responsibilities, please see below:

Essential Functions & Responsibilities

• Adhering to the Agent’s schedule, the Agent is required to be available on the call center ACD to answer customer calls while meeting and exceeding department KPI’s.

• As a team member, researches and resolves inquiries and responds to customers with an appropriate and accurate written or verbal notification.

• Calculates adjustments and creates and processes claims for adjusted payments.

• Creates and processes standard claims, claims with coordination of benefits, pre-treatment estimates, and pretreatment estimates with dated services.

• Maintains and updates subscriber files with information obtained through inquiries and submitted claims and documents, i.e., individual and family on hold codes, applied or removed.

• Performs all tasks necessary to resolve all questions based on Delta Dental’s claims processing guidelines and Dentist handbook, as well as Delta Dental’s website and mobile application.

• Documents each inbound call in call tracking, follow up, or any pended requests.

• Generates check research requests for outstanding payments.

• Understands all claim guidelines and effectively uses this information to resolve related inquiries.

• Researches and resolves requests from other departments such as Marketing and Enrollment.

• When necessary, refers claims or subscriber eligibility to Management or other departments such as Professional Services, Claims, Marketing and Enrollment.

• Supports and participates as needed for inventory reduction tasks such as correspondence and/or call tracking.

• Other duties as assigned

Essential Qualifications

Competencies

Adaptability/Flexibility

Communication

Computer Skills

Customer Focus

Dependability

Job Knowledge

Productivity

Quality

Teamwork

KPI’s

• Adherence standard is 96%
• After call work time – 10 seconds
• Quality: 99%

Technical and Functional Skills

• Ability to regard customer service excellence as a priority
• Personal computer skills with knowledge of MS applications such as Windows, Word and Excel and browser based applications such as Internet Explorer
• Excellent communication and listening skills
• Excellent math aptitude
• Creativity and flexibility when solving problems
• Ability to work in an environment where work is carefully monitored for accuracy

Required Physical Abilities

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Ability to sit and perform extensive close keyboard and PC work including data entry
• Ability to walk, talk or hear
• Occasionally required to stand and reach with hands and arms

Working Environment

• Ability to meet attendance standards.
• Must be able to sit/stand, talk and hear.
• The noise level in the work environment is usually moderate.
• This classification will be required to sign a confidentiality agreement.

Experience, Education and Certifications Required

Experience Required

• 1-3 years customer service/call center experience
• Dental Assistant education/experience is a plus

Required Educational Level

• Requires high school diploma or equivalent.

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