Customer Experience Representative

Provalus 3.7 Customer Experience Representative Easy Apply Monticello, KY Easy Apply Job Summary: Provalus is seeking a dedicated and resilientCustomer Experience Representativeto support a dental insurance provider. This role involves managing a high volume of inbound calls from dental offices, members, and billing departments, with a strong focus on resolving coverage and claims-related issues. Customers rely on you as asubject matter expert in their dental benefits, so professionalism, attention to detail, and empathy are key to success. Training Overview: All new hires will complete a structured4-week training program: Week 1 - Tech Foundry Training:Introduction to systems, tools, and basic workflows Week 2 - Client Training (Part 1):Deep dive into dental insurance terminology, benefits, and claims processes Week 3 - Client Training (Part 2):Advanced topics andshift bidprocess to assign permanent schedules (8.5-hour shifts between 7 AM-7 PM, Mon-Fri) Week 4 - On-the-Job Training (OJT):Begins with call shadowing, group calls, and gradually transitions to independent call handling. By Friday, you are expected to takesolo callsconfidently Key Responsibilities: Handle25-30 inbound calls daily, increasing toup to 50 during peak season (Dec-Apr) Support callers with issues related tocoverage, claim status, denied claims, appeals, andexplanations of benefits (EOBs) Engage with dental office staff to clarify payment issues and patient billing responsibilities Use internal tools andKnowledge-Based Articles (KBAs)to guide accurate information sharing Manage complex, repeat interactionsclaims may require follow-upcalls or investigationup toa 365-day resolution period Qualifications: Prior experience inhealth or dental insurance,call centers, orclaims processingpreferred Strong customer service andconflict resolutionskills Ability tomultitaskand reference tools quickly while on the phone Comfortable working in ahigh-pressure, high-volumeenvironment Willingness tolearn insurance regulations and terminologyyou will be trained to operate like a licensed insurance agent (licensing not required, but SME-level knowledge is expected) Strong communication skills and ability to work independently post-training Job Type: Full-time Benefits: 401(k) Dental insurance Health insurance Paid time off Professional development assistance Referral program Vision insurance Shift: Day shift Evening shift Education: High school or equivalent (Required) Ability to Commute: Monticello, KY 42633 (Required) Work Location: In person See company reviews