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Dental Customer Service Representative - Remote (AK, AZ, FL, ID, OR, TX, WA)

Job Title
Dental Customer Service Representative - Remote (AK, AZ, FL, ID, OR, TX, WA)
Class starts: June 6, 2022
Milwaukie,  OR 97222
Other Location
Job Class: (106) All Oregon, Washington, Idaho, Texas, Arizona, and Alaska

Let’s do great things, together 

Founded in Oregon in 1955, ODS now Moda, is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together.

Moda Health is searching for Customer Service Reps who will provide customer service to our dental members of multiple benefit plans by analyzing the caller’s needs and by providing timely and accurate responses and answer calls from policyholders, agents, members, providers, hospitals, pharmacists and others regarding benefits or other issues.

This position is currently full time work from home and is accepting candidates from AK, AZ, FL, ID, OR, TX, WA. 
Position starts June 6, 2022.
Primary Functions:

  1. Answer claim benefit questions from callers on both group and individual products.  Provide solutions to problems, confirm eligibility, explain benefits and/or plan coverage.
  2. Provide accurate information in a professional manner.
  3. Apply mathematical skills to determine correct benefit information.
  4. Exercise judgment, initiative, and discretion in confidential and sensitive matters.
  5. Perform related duties:
    • Review, update and become familiar with new and revised benefit information or claim processing procedures.
    • Update and enter primary care physician selections and coordinate with Group Integration.
    • Request claim adjustments required because of error or new information.
    • Resolve and record complaints, appeals, and inquiries.
    • Provide customer service to walk-in members.
    • Contact physicians, dentists, hospitals, and other providers when necessary to answer questions and obtain or provide information.
    • Provide timely follow-up and return calls when these are required.
    • Answer calls within service level time.
    •  Perform other related duties as assigned.

Are you ready to be a betterist?

If you’re ready to make a difference that matters, we want to hear from you. Because it’s time to discover what’s possible.

Together, we can be more. We can be better.

Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law.

Required Skills

01. High school diploma or equivalent.
02. 10-key proficiency of 105 kspm net on a computer numeric keypad.
03. Type a minimum of 35 wpm net on a computer keyboard.
04. Ability to achieve and maintain quality and quantity standards.
05. Some knowledge of Insurance terminology and practices.
06. Data Entry experience dealing with all types of plans.
07. Good reading, verbal and written communication skills. Ability to listen and communicate clearly and interact professionally, patiently and courteously with co-workers and supervisor.
08. Analytical, problem solving, and decision making skills. Detail oriented and good memory retention with ability to shift priorities.
09. Good organizational skills, ability to work well under pressure and ability to handle a variety of functions in order to meet timelines.
10. Ability to come into work on time and on a daily basis.
11. Ability to maintain confidentiality and project a professional business image.
12. Ability to work in a fast paced environment.
13. High speed internet (cable or fiber).
Should you need an accommodation in applying to any of our open positions, please contact Human Resources at or 503-228-6554.