You are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll have new and exciting opportunities to make life brighter for our Clients - who are at the heart of everything we do. Discover how you can make a difference in the lives of individuals, families and communities around the world.

DentaQuest manages dental and vision benefits for more than 33 million Americans. Our outcomes-based, cost-effective solutions are designed for Medicaid and CHIP, Medicare Advantage, small and large businesses, and individuals. With a focus on prevention and value, we aim to make quality care accessible to improve the oral health of all.

JOB SUMMARY:

The Customer Service Representative I position interacts with customers to provide and process information in response to general inquiries, concerns, and requests about products and services. The CSR I must project a professional company image and provide superior customer service by corresponding with customers via any of DentaQuest’s customer contact channels.

PRIMARY JOB RESPONSIBILITIES:

• Responds to customer inquiries in a courteous and professional manner.
• Research assistance requested and consistently provides accurate information to resolve internal and external member and provider inquiries via verbal and written communications through all channels including phone, email, web portal, and chat interactions.
• Thoroughly and completely document all customer interactions.
• Educates customers and dental professionals on eligibility, benefits, claims payment, and authorizations.
• Provides direction on the usage and benefits of self-service tools.
• Assist members on gaining access to care by locating a network dentist or assignment to a primary care dentist.
• Appropriately routes inquiries to the necessary departments or individuals when resolution of the inquiry is beyond the span of control of this role.
• Meets or exceeds individual, department, and client specific goals.
• Understands and adheres to all of DentaQuest’s administrative and contractual policies and procedures.
• Contributes to the success of the organization by suggesting ways to improve the service delivery processes.
• Other duties as assigned.

JOB REQUIREMENTS:

• High School Diploma or Equivalent.
• 2 years of experience in a high-volume customer service environment.
• Proven professional verbal and written communication skills.
• Ability to efficiently operate a computer and knowledge of Microsoft Office applications.
• Strong organizational skills and attention to detail.
• Ability to work independently and with a team.
• Ability to learn quickly and adapt to a fast-paced production environment.
• Cooperative, professional and effective interaction skills with co-workers, company staff and visitors.
• Critical thinking and problem-solving skills.
• Ability to tolerate repetitive work without compromising accuracy and service levels.
• Required to attend additional training as requested/deemed necessary.

Preferred:

• Dental terminology knowledge and group health insurance experience a plus.
• Experience with Avaya phone system a plus.

PHYSICAL DEMANDS:

• Incumbent must be able to communicate effectively.
• Requires overall light physical effort (up to 25lbs.)
• Manual dexterity and sitting is required in carrying out position own position responsibilities (i.e. use of personal computer).
• Ability to travel or move about within and outside serviced facilities required.
• Incumbent works primarily in either a private or shared office environment.

The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria necessary to successfully perform this position.

** In accordance with DentaQuest’s Compliance Plan, employee must conduct DQ business in accordance with applicable laws, regulations, professional standards and ethical standards and report potential compliance or ethical issues to manager or DQ’s Compliance Officer. **

DentaQuest’s Affirmative Action Program affirms our commitment to make reasonable accommodation to the known physical or mental limitation of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please see Human Resources for additional information regarding this Program.

Our Affirmative Action Program affirms our commitment to make reasonable accommodation to the known physical or mental limitation of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email recruitingUS@sunlife.com to request an accommodation.

At Sun Life we strive to create a flexible work environment where our employees are empowered to do their best work. Several flexible work options are available and can be discussed throughout the selection process depending on the role requirements and individual needs.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran