Willamette Dental Group

  • Member Services Representative

    Job Locations OR-Hillsboro
    Job Req #
    # of Positions
    Job Post Information* : Posted Date
    3 months ago(12/28/2018 8:00 AM)
    Pos. Category
    Member Services - Positions
    Pos. Type
    Full Time Regular
    5 8-Hour Days
  • Company Overview

    With more than 400,000 patients throughout our 50+ practice locations in Oregon, Washington, and Idaho, and a built-in specialty referral network to more than 30 specialists, Willamette Dental Group has been a leader in preventive and proactive dental care since 1970. What makes this multi-specialty group practice unique, and better, is a commitment to proactively facilitating the best possible health outcomes.

    As a member of the Willamette Dental Group team, we offer a competitive salary commensurate with experience. We are a performance based culture and offer a generous and comprehensive benefit package. Among the many amenities we offer are medical, dental, vision, life insurance, paid time off (PTO), paid holidays, and a robust wellness program. Additionally, we offer a 401(k) plan with a generous employer match, tuition assistance, discounted monthly Trimet pass, and much more. Our Hillsboro, Oregon Administrative Headquarters are conveniently located in the growing Orenco Station neighborhood, just blocks from the MAX stop and within easy walking distance to many local shops and restaurants.

    Job Responsibilities

    The Member Services Representative communicates with members via incoming calls to efficiently and effectively answer membership questions regarding benefit eligibility, performs outreach communications and handles all inquiries within the scope of the position’s responsibility.

    Essential Position Functions
    •Respond to Member calls in a courteous and professional manner, answering questions and inquiries regarding membership eligibility, benefits, claims, notice of actions or adverse benefit determinations, grievance processes, policies and procedures. Completes forms and other paperwork as needed, and document all incoming and outgoing calls.
    •Educate members on the guidelines of their dental benefits with the company and their insurance partners. Understand and clearly communicate Willamette Dental Group systems, processes, policies and treatment services to members.
    •Assess and resolve problems within the scope of authority; escalates complex questions or problems to more experienced representatives or higher authority level.
    •Identify complaints and understand how to facilitate the process with the Practice or Member Services Grievance, Appeal and Care Coordination.
    •Supports various outreach programs

    Job Qualifications

    High School Diploma or equivalent and two years of customer service experience in a high volume call center; or any equivalent combination of education and/or experience which leads to the ability to perform the essential functions of the position. Experience in communicating benefits to members with diverse backgrounds and cultures preferred.

    Knowledge of:
    •Dental terminology and procedures.
    •Standard office equipment including personal computers, database entry and Microsoft suite of applications to communicate and convey information.
    •Oregon Administrative Rules (OARs) and regulations overseen by Centers for Medicare and Medicaid Services (CMS) relating to services provided by Willamette Dental Group and timelines necessary to ensure compliance.
    •Insurance policies, contracts and consumer rights.

    Skill in:
    •Verbal and written communications and being able to diffuse difficult conversations.
    •Decision-making, problem-solving and organizational agility.
    •Keyboarding including 10 key.
    Ability to:
    •Provide outstanding customer service.
    •Identify complaints and understand when to escalate call to other team members.
    •Maintain clear and open lines of communication between the Practices and Member Services.
    •Understand and clearly communicate to members how to access and utilize plan benefits.
    •Demonstrate cultural competency and interact with members from very diverse backgrounds and cultures.


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