Dentaquest - Contact Center Customer Service Rep - RECRUITED - US

Job Summary

The DentaQuest Contact Center Customer Service Representative plays a pivotal role in delivering high-quality service to members and providers by efficiently resolving inquiries related to dental insurance benefits, claims, and provider networks. This remote position supports DentaQuest s mission of improving oral health by ensuring customers and dental professionals receive prompt, accurate, and professional assistance. The ideal candidate demonstrates strong call center experience and health insurance knowledge, with a commitment to compliance, accuracy, and service excellence.

Key Responsibilities

• Respond promptly and professionally to inbound customer and provider inquiries across multiple channels (phone, email, chat, web portal).
• Educate callers on eligibility, benefits, claims payment, and authorizations.
• Assist members in locating network dentists and assigning primary care dentists.
• Accurately interpret and communicate insurance coverage and policy details.
• Resolve claim payment and coordination of benefits inquiries by researching patient activity and taking appropriate action.
• Thoroughly document all customer interactions in the system.
• Route complex issues to appropriate departments and ensure follow-up.
• Promote and guide customers in the use of self-service tools.
• Meet or exceed individual and departmental performance targets.
• Suggest process improvements to enhance service delivery.
• Adhere to all administrative, contractual, and compliance policies.
• Participate in required and additional training as needed.

Recruiter Insights

Candidate Insights

This role is ideal for candidates seeking to make a meaningful impact in healthcare customer service, with opportunities for professional growth and skill development in a dynamic, supportive environment.