Winmax

Telephone Inquiry Specialist

Location: Rancho Cordova, CA Contract: 7+ Month Work Schedule (Shift/Work Hours): 5 days onsite (work hour: 8am start) M-F

Job Description:

• Researches, resolves and responds to complex telephone inquiries that cannot be answered immediately by the Toll Free Telephone Representative and monitors cycle time reports. Processes in-house documents-CIFs, NOAs, Claims, TARs and RTDs.
• Responds to incoming calls from Medi-Cal dental Beneficiaries and/or their representatives concerning general program policies, regional screening appointments, Treatment Authorization Request (TAR) Notifications, complaints; refers callers to Denti-Cal providers; reschedules regional screening appointments; refers callers to other agencies or resources. Tracks call information in the Beneficiary Correspondence Tracking System.
• Responds to incoming calls from Denti-Cal provider offices regarding program policies/procedures, claims/TARs processing, EOB and check inquiries; provides patient history information and office enrollment status. Tracks call information in the Provider Correspondence Tracking System.
• Miscellaneous projects as assigned.

Skills/Experience: Job Requirements:

• Dental Assisting Certificate from an accredited dental assisting school and/or a minimum of two years dental assisting experience in a dental office.
• Pass DDC Dental Auditor V test and x-ray reading test.
• One year communication experience.
• Must be able to work regular overtime as required.
• Knowledge of Denti-Cal provider billing procedures and claims adjudication processes
• Medi-Cal rules and regulations, dental codes, procedures and practices preferred
• Skills in communication, problem solving, basic math and use of computer tools.
• Knowledge of dental anatomy, physiology, pathology and nomenclature used in the dental office.
• Ability to handle detailed work.
• Ability to maintain confidentiality.
• Ability to handle multiple concurrent tasks.
• Customer contact skills.
• Ability to handle constant interruptions.
• Stress management skills.
• Reasoning skills.

Pay Transparency: The expected pay range for this position is $18.00–$20.00 per hour. Final compensation will be determined based on experience, skills, and qualifications. Non-exempt employees are eligible for overtime. Full-time employees are eligible to select from different benefits packages. Packages may include medical, 401(k) without employer match. Paid Sick leave is provided based on state or local laws.