Customer Experience Representative

• 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

• 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

• 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

LaSalle Network is an Equal Opportunity Employer m/f/d/v.

All assignments are at-will and their duration is subject to change.