***Candidates must reside in one of the following states: NC, FL, GA, IN, KS, SC, VA*** Title: Dental Customer Service Representative | FLSA Status: Non exempt | Shift: 7.5 hours/day, 37.5 hours/week Flex hours between 8:00 am to 6:00 pm Monday through Friday, occasional OT | Reports to: Dental Customer Service Supervisor | Department: Dental | Employment Status: Full Time | Supervisory Responsibilities: No | | Date Created/Last Evaluated: March 2026 | Summary The Dental Customer Service Representative is responsible for handling incoming calls from members, providers, brokers and group administrators to verify eligibility, verify benefits, explain EOB’s, research claim payments and answer general questions in a call center environment. | Qualification Requirements: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. | Minimum Qualifications - High School Graduate or General Education Degree (GED)
- At least 2 years of related experience
- Dental terminology experience, preferred
- Bilingual, preferred
| Knowledge, Skills and Abilities - Excellent verbal and written communication skills required
- Ability to utilize the available time to organize and complete work within given deadlines
- Ability to meet company metrics
- Ability to work independently with minimal supervision
- Ability to communicate clearly and concisely in spoken and written word
- Ability to take care of the customers’ needs while following company procedures
- Ability to pay attention to the minute details of a project or task
- Ability to get along well with a variety of personalities and individuals
- Ability to remain calm under pressure
| Essential Functions - Confer with customers by telephone to provide information about dental services, eligibility and plan benefits
- Ensure department metrics are met by call volume and minimum talk time. Call monitoring must verify minimum number of errors and customer complaints
- Remain calm when speaking with callers who may become upset
- Keep records of customer interactions and transactions, record detail of inquiries, complaints, and comments in the system, as well as any actions taken
- Check to ensure that appropriate changes were made to resolve customer’ problems
- Refer unresolved customer grievances to designated departments for further investigation
- Documents all calls in a clear and concise manner
- Obtain and examine all relevant information to assess validity of complaints and to determine possible causes, such as eligibility, and handle claims questions regarding payments or denials
- Review dental insurance policy terms to determine whether a particular service is covered by insurance
| Physical Demands Heavy phone usage and use of computer equipment. This is a sedentary role. | Work Environment Remote work-from-home position. Requirements are a dedicated workspace with minimal distractions. | The Company has reviewed this job description to ensure that essential functions and basic duties have been included. It is intended to provide guidelines for job expectations and the employee's ability to perform the position described. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. This document does not represent a contract of employment, and the Company reserves the right to change this job description and/or assign tasks for the employee to perform, as the Company may deem appropriate. |
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