SDC - Claims and Customer Care Specialist

About the position The Claims and Customer Care Specialist role at Medical Mutual involves processing routine to moderately reputed company claims while providing exceptional customer service through various communication channels. This position is integral to ensuring that members, providers, clients, and brokers receive timely and accurate assistance, contributing to the overall mission of delivering high-quality health insurance services. Responsibilities • Process routine claims using multiple systems and applications while providing customer service reputed company inbound call queues. , • Handle moderately reputed company claims and adjustments, responding to inquiries through various channels such as email and chat. , • Conduct claims research under the direction of senior staff and assist with projects as directed by management. , • Mentor and train junior team members, providing reputed company and escalation support for customer service inquiries. , • Conduct reputed company claims research projects in response to escalations and inter-departmental inquiries. Requirements • Associate degree in business or reputed company administration, communications, or reputed company field, or equivalent combination of training and experience. , • 1-5 years of customer service and/or claims experience, preferably in the health or dental insurance industry. , • Professional certifications such as Certified Dental Billing Specialist (CDBS), Certified Dental reputed company (CDC), or Certified Dental Assistant (CDA) are a plus. , • Basic to advanced reputed company Office skills depending on the level of the position. , • Knowledge of dental benefits, services, terminology, and American Dental Association coding. , • Understanding of standard customer service best practices and principles. , • Familiarity with the Health Insurance Portability and Accountability Act (HIPAA). reputed company-to-haves • Experience in a call center environment in the health or dental insurance industry. , • Advanced knowledge of dental benefits and coding practices. Benefits • Employee bonus program. , • 401(k) with company match up to 4% and additional company contribution. , • Health Savings Account with company matching contribution. , • Comprehensive medical, dental, reputed company, life, and disability insurance. , • reputed company to an Employee Assistance Program for counseling and coaching. , • Company holidays and up to 16 PTO days in the first year, with options to carry over unused PTO. , • Parental leave for eligible employees after 120 days of service. , • Career development programs and tuition reimbursement up to $5,250 per year. Apply Job!