ibex

Customer Support

• Provide guidance on provider networks, referrals and pre-authorizations.
• Troubleshoot and resolve issues related to billing, payments and coverage.
• Ensure compliance with HIPAA regulations when handling sensitive member information.
• Collaborate with internal departments to resolve complex member concerns.
• Maintain accurate records of customer interactions and resolutions in CRM systems.
• Meet performance metrics such as response time, resolution rate and customer satisfaction scores.
• Stay updated on policies, state regulations and healthcare industry changes.

Korean Bilingual Customer Service Representative

Bilingual Customer Service Representative, Mandarin/Cantonese

Vietnamese Bilingual Customer Service Representative

• Resolving coordination of benefits inquiries by analyzing patient activity (including enrollment, third party liability, claims attachments).
• Having a comprehensive understanding of insurance coverage and being able to interpret and communicate accurate information.
• Thoroughly and completely documenting all customer interactions.
• Educating customers and dental professionals on eligibility, benefits, claims payment, and authorizations.
• Educating on the usage and benefits of self-service tools.
• Assisting members on gaining access to care by locating a network dentist or assignment to a primary care dentist.
• Directing inquiries to necessary departments or individuals when the resolution of the inquiry is beyond the span of control for this role.
• Researching and consistently providing accurate information to resolve all member and provider inquiries through verbal and written communications through all channels including phone, email, web portal, and chat interactions.
• Responding to and resolving internal and external complex customer inquiries.
• Resolving claim payment inquiries by researching and analyzing patient activity and determining appropriate action to be taken.
• Taking ownership of the resolution and setting expectation for follow up.
• Ensuring resubmissions, stop payments, and voids are appropriately handled.
• Meeting or exceeding individual, department, and client specific goals.
• Understanding and adhering to all client administrative and contractual policies and procedures.
• Suggesting ways to improve the service delivery processes contributing to the success of the organization.