Customer Experience Representative

Customer Experience Representative – Dental Benefits
Employment Type: Direct Hire
Pay: $21–$23/hour
Benefits: Health, Dental & Vision options available

About the Opportunity
We are seeking a Customer Experience Representative to join a growing healthcare organization and provide exceptional service to members, providers, brokers, and group administrators. This is a direct-hire opportunity offering $21–$23/hour along with health, dental, and vision benefit options.

This role is ideal for someone with strong customer service skills who is comfortable working in a fast-paced environment and has experience with healthcare benefits, insurance, claims, or dental terminology. You will serve as a primary point of contact, helping customers understand and resolve questions related to dental benefits and claims.

What You'll Do

• Serve as a primary point of contact for subscribers, providers, brokers, and group administrators, answering questions and resolving concerns related to dental benefits and claims

• Assist with dental claim inquiries, adjustments, discrepancies, and other benefit-related questions

• Review claims and troubleshoot more complex cases using established guidelines and business rules

• Investigate potential overpayments and assist with claim adjustments and resolution

• Explain benefit information, including deductibles, maximums, coordination of benefits (COB), reimbursement, and other dental insurance concepts

• Accurately document customer interactions, adjustment requests, investigations, and follow-up activity

• Maintain detailed records and reports to support case management and resolution

• Navigate multiple systems while communicating with customers and researching information

• Escalate or route complex issues to the appropriate internal resources when necessary

• Maintain confidentiality and follow all privacy and security requirements related to electronic Protected Health Information (ePHI)

• Participate in ongoing training, special projects, and team initiatives

• Provide support and guidance to newer team members as experience is gained

What We're Looking For

• Previous experience in customer service, healthcare, insurance, benefits, dental, or claims processing

• Strong verbal and written communication skills

• Ability to provide professional service while handling potentially complex or sensitive customer concerns

• Strong attention to detail, problem-solving, and documentation skills

• Ability to multitask and manage multiple priorities in a fast-paced environment

• Comfortable working in a call center/ACD environment with established talk-time and work-time expectations

• Familiarity with dental terminology, claims processing, insurance reimbursement, deductibles, maximums, and coordination of benefits is highly preferred

• Strong computer skills and ability to learn new systems

• Ability to work independently while contributing to overall team goals

• Reliable attendance and punctuality

• High school diploma or equivalent required

Preferred Qualifications

• Bilingual Spanish/English

• Previous dental insurance or dental benefits experience

• Experience reviewing dental photos, X-rays, or provider narratives

• Additional healthcare or dental-related education, certification, or training

Why Join?
This is a direct-hire opportunity that offers long-term stability and the chance to grow within the healthcare and dental benefits industry. The position offers $21–$23/hour with health, dental, and vision options available, along with ongoing training and opportunities for professional development.

If you are customer-focused, detail-oriented, and interested in building your career within healthcare benefits and insurance, we would love to hear from you!

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