Provalus is seeking dedicated and resilient Customer Experience Representatives to 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 a subject matter expert in their dental benefits, so professionalism, attention to detail, and empathy are key to success.

• 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 and?shift bid?process to assign permanent schedules (8.5-hour shifts between 8 AM–78PM EST, 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 take solo calls confidently

• Handle 25–30 inbound calls daily, increasing to up to 50 during peak season (Dec–Apr)
• Support callers with issues related to coverage, claim status, denied claims, appeals, and?explanations of benefits (EOBs)
• Engage with dental office staff to clarify payment issues and patient billing responsibilities
• Use internal tools and Knowledge-Based Articles (KBAs) to guide accurate information sharing
• Manage complex, repeat interactions—claims may require follow-up calls or investigation up to a 365-day resolution period

• Strong customer service and conflict resolution skills
• Ability to multitask and reference tools quickly while on the phone
• Comfortable working in a high-pressure, high-volume environment
• Willingness to learn insurance regulations and terminology—you 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

Work Location: In person