Healthcare Member Services Specialist/Receptionist

Job Description

Job Description

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

Do you value making an impact and doing meaningful work? Are you ready to be a difference-maker at an established independent Employee-Owned specialized healthcare company?

If you enjoy working with a team of caring and dedicated people, this could 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 research 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.

Support 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 maintaining 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.
• Answer 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 interface with other departments to collect data necessary to respond to inquiries.
• Actively seeks to identify member problems and work to resolve them in a timely manner and confirms caller satisfaction in all interactions.
• Greet and welcome guests and visitors, ensuring they register into 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 reception area is tidy and presentable, with all necessary stationery and material (e.g. pens, forms, and brochures)
• 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 supports 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 maintains / publishes 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.
• Supports other departmental staff and management with special projects as directed and assigned.
• Performs 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 look forward to having you on our team!