Healthcare Member Services Specialist/Receptionist - Seattle, United States - Dental Health Services

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    Job Description

    Job Description

    You'll contribute to the strength of our team approach to collaborative dental health.

    If you value making an impact and doing meaningful work, and you're ready to be a difference-maker at an established independent Employee-Owned specialized healthcare company, this might be your new home!

    Job Summary

    The Member Services Specialist/Receptionist addresses member inquiries, questions, and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for dental care. Responsible for receiving, responding to, and directing member phone calls or written questions. Provides available information upon request and researches or escalates issues as appropriate. Maintains confidentiality per HIPAA guidelines. Responsible for performing a variety of duties associated with greeting and receiving visitors, receiving, and directing calls, and providing a variety of clerical, administrative, and mail processing support functions for the Company facility. Supports office personnel as directed and required.

    Essential Responsibilities

    • Provides information and guidance in response to telephone inquiries from members, dentists, brokers, and group contacts in a professional and supportive manner.
    • Acts as a mediator for members, groups, providers, and others to resolve problems and concerns, and answer questions based upon Dental Health Services company plans, policies, and procedures.
    • Maintains daily and pending phone logs for accurate department records and follow-ups.
    • Assists dental offices and members in verifying and communicating member eligibility. Makes arrangements for member second opinions and authorizes emergency referrals.
    • Answers questions members may have regarding treatment and charges.
    • Provides plan benefit information to existing members. Assists in keeping all member information updated in data systems.
    • Researches files, checks billing, and interfaces with other departments to collect necessary data to respond to inquiries.
    • Actively seeks to identify member problems and work to resolve them promptly and confirm caller satisfaction in all interactions.
    • Greet and welcome guests and visitors, ensuring they register at the facility, are issued a badge, and escorted beyond the reception area by another authorized employee.
    • Answers, screens, and forwards incoming phone calls to the appropriate person and/or department to ensure high caller service and support.
    • Ensure the reception area is tidy and presentable, with all necessary stationery and material available.
    • Provide basic and accurate information in-person and via phone/email in a pleasant manner, properly representing the Company to all callers and visitors.
    • Receive and distribute packages and mail and support return mail processing and data input for correction.
    • Maintain office security by following safety procedures and controlling access via the reception desk (monitor logbook, issue visitor badges, etc.).
    • Update calendars, schedule meetings, and maintain/publish daily Out-Of-The-Office list.
    • May arrange travel and accommodations for employees and/or visitors.
    • Perform other clerical receptionist duties such as filing, photocopying, scanning, and faxing.
    • Support other departmental staff and management with special projects as directed and assigned.
    • Perform any and all additional duties as requested and directed for this position.

    Basic Qualifications

    Experience

    • Minimum of 1-2 years of related experience

    Education

    • High school diploma or equivalent
    • Some college preferred

    License, Certification, Registration

    • Notary (within 3 months of employment)

    Additional Requirements

    • Excellent interpersonal, oral, and written communication skills
    • Computer literacy is required
    • Well organized
    • Detail-oriented

    Preferred Qualifications

    • Knowledge of dental terminology and procedures
    • Bilingual English/Spanish
    • Previous experience in a customer service call center

    Position Details

    • Primary Location: Seattle, Washington
    • Job Schedule: Full time
    • Scheduled Weekly Hours: 40
    • Shift: Monday - Friday between the hours of 8:00 am to 6:00 pm, Overtime as needed
    • Travel: Yes, less than 15%

    We are excited to welcome you aboard our team!