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.