Let’s do great things, together!
Founded in Oregon in 1955, 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.
Provide customer service to members of multiple benefit plans by analyzing the caller’s needs and by providing timely and accurate responses. Answer calls from policyholders, agents, members, providers, and others regarding benefits or other issues.
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This position is currently full time work from home and is accepting candidates from AK, AZ, FL, ID, OR, WA. Must be able to work on PST time zone.Position starts August 14th 2023.
Starting Salary: $18/hr
To apply please visit the link below and complete an application to be considered for this position.
- https://j.brt.mv/jb.do?reqGK=27706545&refresh=true
Benefits:
- Medical, Dental, Vision, Pharmacy, Life, & Disability
- 401K- Matching
- FSA
- Employee Assistance Program
- PTO and Company Paid Holidays
- PST
- Monday - Friday
Required Skills, Experience & Education:
- High school diploma or equivalent.
- Practical knowledge of medical or dental terminology desired.
- Knowledge of diagnosis and procedure coding desired.
- Claim processing experience or prior customer service experience or other related experience such as medical/dental office experience.
- Strong reading, oral and written communication skills. Ability to interact professionally, patiently, and courteously with customers over the phone and in person.
- Good analytical, problem solving and decision-making skills.
- 10-key proficiency of 105 kspm net on a computer numeric keypad.
- Type a minimum of 25 wpm net on computer keyboard.
- Ability to work with multiple system applications.
- Ability to work well and independently under pressure in a complex and rapidly changing environment.
- Ability to start work on time and daily.
- Ability to remain focused and on task in a work from home environment.
- Maintain confidentiality and project a professional business presence and appearance.
- Ability to repeatedly analyze situations and communicate effectively in a fast-paced environment that includes dealing with escalating queries and concerns.
- Ability to organize and remain up to date on changing and new information.
- Knowledge and understanding of Delta Dental administrative policies is desired.
- Maintain attendance within company standards.
- Ability to troubleshoot and follow protocols for reporting issues.
- Answer dental claim, benefit, and eligibility questions from callers for group, Oregon Health Plan (OHP) and individual products. Provide solutions to problems, confirm eligibility, explain benefits and/or plan coverage.
- Provide accurate information and/or plan coverage in a professional manner.
- Apply mathematical skills to determine correct benefit information.
- Exercise good judgement, initiative, and discretion in confidential and sensitive matters.
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Perform related duties:
- Follows HIPAA guidelines to protect member health information.
- Able to document all aspects of a call in a clear and concise manner.
- Review, and become familiar with new and revised benefit information or claim processing procedures.
- Identify and request claim adjustments when necessary.
- Resolve and record complaints, appeals, and inquiries.
- Provide one call resolution, when possible, by extending yourself. This could include contacting providers, other insurance companies or state agencies 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 duties as assigned
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.
For more information regarding accommodations please direct your questions to Kristy Nehler and Daniel McGinnis via our humanresources@modahealth.com email.
