CSR and Claims Processor
7 days ago
Tampa
Job Description About the Role We’re looking for detail-oriented, people-focused team members who want to provide outstanding service while ensuring our clients and providers receive accurate, timely claims processing. If you have experience in the dental industry, dental billing, or dental claims payment, you’ll be given first consideration. This is an in-person position at our Gulf Breeze, FL office. What You’ll Do Claims Processing & Administration • Adjudicate dental and benefits claims according to policy and contract requirements., • Review claims and request additional information as needed by completing claim adjustments or reaching out via phone, email, or letters., • Determine claim resolutions within established guidelines and timelines., • Reference our benefits policy manual and other resources to ensure accurate, compliant decisions., • Research and troubleshoot claim issues, escalating complex situations to the appropriate department when needed., • Take inbound calls from clients, members, and providers, delivering best-in-class, first-call resolution customer service., • Clearly explain benefits, claim decisions, and next steps in a professional and empathetic manner., • Use multiple software applications and online tools to research and resolve inquiries., • Participate in ongoing training on multiple software applications and updated processes., • Adapt to new technologies and systems as they are implemented., • Identify and share opportunities to improve processes and enhance the customer experience., • Work collaboratively in a fast-paced, team-oriented, and innovative environment. Qualifications Required • High school diploma or equivalent., • Excellent written and verbal communication skills., • Strong attention to detail and accuracy., • Ability to thrive in a fast-paced environment with changing priorities., • Intermediate skills in Microsoft Office (Word, Excel, Outlook) and virtual communication tools (e.g., Microsoft Teams, Zoom)., • Ability to understand and follow policies and procedures related to the release of information and HIPAA regulations., • Regular and predictable attendance., • Dental industry experience (front office, billing, claims, or insurance coordination)., • Experience with dental billing or dental claims payment., • Experience in benefits claims and/or consumer-driven health plans., • Ability to work extended hours during peak season (generally late November through February) to support higher call and claims volume and maintain service standards. Schedule • Day shift, • Monday through Friday, • Occasional extended hours during peak season as needed. Compensation & Benefits • Pay: $16.00 – $20.00 per hour (commensurate with experience)., • Benefits may include:, • 401(k) with company match, • Health insurance, • Dental insurance, • Disability insurance, • Life insurance, • Flexible Spending Account (FSA), • Flexible schedule (within business needs) How to Apply Please submit your resume and be prepared to answer the following question: Do you have experience with Dental Billing or Dental Claims Payment? Equal Opportunity Employer Cafeteria Plan Services, Inc. (CPS) is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, sexual orientation, gender identity, disability, or protected veteran status. CPS complies with all applicable federal, state, and local laws governing nondiscrimination in employment in every location in which we operate. If you require a reasonable accommodation to complete the application, participate in interviews, complete any pre-employment testing, or otherwise take part in the selection process, please contact Human Resources. If you’d like, I can also shorten this for a specific job board (Indeed, LinkedIn, etc.) or tailor it for internal vs. external posting. You said: design it for Ziprecruiter ChatGPT said: Thought for 9s Here’s a ZipRecruiter-ready version you can paste straight into the job posting form: Job Title: Customer Service Representative & Claims Processor (Dental Benefits) Company: Cafeteria Plan Services, Inc. (CPS) Location: Gulf Breeze, FL 32561 (In-Person Only) Pay: $16.00 – $20.00 per hour (DOE) Job Type: Full-time | Day Shift | Monday–Friday About the Role Cafeteria Plan Services, Inc. is looking for a Customer Service Representative & Claims Processor to join our in-office team in Gulf Breeze, FL. In this role, you’ll review and process dental and benefit claims, assist callers with questions about their benefits, and help ensure our clients and providers receive accurate and timely service. If you have experience with dental billing or dental claims payment, we want to talk to you! What You’ll Do • Review and adjudicate dental and benefits claims according to policy and contract requirements, • Request additional information by phone, email, or letters when needed, • Determine claim outcomes within established guidelines and timelines, • Research and resolve claim issues; escalate complex cases to the appropriate department, • Take inbound calls from clients, members, and providers and provide first-call resolution whenever possible, • Clearly explain benefits, claim decisions, and next steps to callers, • Use multiple software systems and tools to research and document accounts, • Meet performance expectations for accuracy, productivity, quality, and turnaround time, • Participate in ongoing training and adapt to new technologies, policies, and processes What We’re Looking For Required: • High school diploma or equivalent, • Strong written and verbal communication skills, • Excellent attention to detail and accuracy, • Ability to thrive in a fast-paced, team-oriented environment, • Intermediate skills in Microsoft Office (Word, Excel, Outlook), • Comfortable using virtual tools (Teams, Zoom, etc.), • Ability to understand and follow policies related to HIPAA and release of information (training provided), • Reliable, with regular and predictable attendance, • Experience with Dental Billing or Dental Claims Payment, • Dental industry experience (front office, insurance coordination, claims), • Experience in benefits claims and/or consumer-driven health plans, • Willingness to work extended hours during peak season (typically late November through February) to support higher call and claims volume Schedule • Day shift, • Monday – Friday, • Full-time, in-person Pay & Benefits • Pay: $16.00 – $20.00 per hour (based on experience), • Benefits may include:, • 401(k) with company match, • Health insurance, • Dental insurance, • Disability insurance, • Life insurance, • Flexible Spending Account (FSA), • Flexible schedule (within business needs) Equal Opportunity Employer Cafeteria Plan Services, Inc. is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin