Job Description

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


- Attractive remote opportunity for Maryland-based talent with competitive pay, especially for bilingual (Mandarin/Spanish) candidates.
- Structured training and clear performance metrics support employee success.
- Stable weekday schedule with predictable hours and minimal overtime.
- Preference for candidates with additional healthcare industry skills, enhancing team effectiveness.
- Strong compliance and inclusion policies create a professional and supportive work environment.


Candidate Insights


- Gain valuable experience in a reputable healthcare organization with a mission-driven culture.
- Opportunity to leverage and grow customer service and health insurance expertise.
- Bilingual skills are rewarded with higher pay.
- Comprehensive training ensures a smooth transition into the role.
- Supportive remote setup with provided equipment, clear expectations, and ongoing learning opportunities.


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.

Job Tags

Weekday work,

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