Effective Customer Service Representative with 3 years of experience assisting customers using active listening and customer needs assessment to offer targeted solutions. Consistently friendly and professional when handling diverse customer needs in high-volume call center environments. Smoothly manage workflow and optimize team strengths to meet service quotas.
Administrative Support, Attention to Detail, Team Building, Scheduling, Strong Communicator, Highly Motivated, Dependable, Quick Learner, Outgoing, Strong computer keyboard skills, Microsoft Work, Excell and Outlook. Ability to perform routine mathematical computation, evaluate/interpret dental records and plan documents to make appropriate benefit determinations. Knowledge of work processing applications in a window environment. Excellent communication skills, detail oriented, self-motivated, demonstrate professional attitude and work independently with minimal supervision.
Uses knowledge of products and contractual provisions that govern administration to provide customer service and education, to interpret contractual language to the customer for the purpose of providing benefit utilization and limitation, to determine the need and to administer all types of services to customers with the business segment through telephonic inquiries, written and/or electronic inquiries and adjustments. Provide quality customer service while continually demostrating flexibility in responding to varying benefit exceptions within each line of business according to the established quality, productivity and performance metrics. Learn, retain and effectively utilize automated processes and other appropriate systems, program, special condition exceptions, dental knowledge and processing polices to resolve inquiries. Expeditiously access reference material, claim image lookup, etc....to analyze and determined appropriate response to complex telephone, electronic and written inquiries from dental professionals, groups, subscribers, dependants, dentists, dental staffers and other callers in a professional manner. Document each interaction encountered through to resoluation in the appropriate Computer Inquiry Tracking System (CITS). Update coordination of benefit information, as required. Evaluate and generate requests for claim overpayment/underpayment conditions discovered under the patient's claim history. Complete claim adjustments, as required. Direct unresolved grievances to the designated department for further investigation. Continuously evaluate and identify opportunities to drive process improvement that negatively impacts the customer's experience. Generate requests for faxback, ID cards, benefit booklets, explanation of benifts, etc. Partipates in a required training of paying out claims, deductibles, maximums, coordination of benefit (COB) and dental terminology/coding.
Ensured fundamental systems and protocols were in place within the dental office, allowing the doctor to focus on dentistry. Maintained the office budget to achieve profitability, assist in team development, built postive relationships with the dentist, Practice Administrator and team members. Managed schedules to meet daily goals and assumed a leadership role in motivating office team members and proactively seeking ways to improve the practice. Emphasized patient service by ensuring world-class office phone service, updating team members on communication tools and focusing on patient advocacy. Oversaw daily office operations for a staff of 11 employees. Trained new employees on multiple dental billing programs and data entry software. Performed accounts recievable duties including invoicing, researching chargebacks, discrepancies and reconciliations. Managed team calendar and coordinated weekly project team meetins.
Maintained and organized all administrative functions in the front office, including reception tasks. Received and distributed office mail and email, answered office phones and distributed call or messages accordingly. Communicated patient's arrival promptly. Managed administrative records and pulled/files office charts. Worked with administrative scheduling, including maintaining office records, documenting patient dental treatments and transactions. Followed office procedures for patient referrals and scheduling of office appointments. Maintained office accounts receivable information, making financial arrangements with patients before treatments and ordering office and administrative supplies. Prepared payroll for 11 staff members.
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