Call Center Representative

Position Summary

The Dental Call Center & Insurance Verification Representative serves as a key point of contact for dental patients by providing exceptional customer service, appointment scheduling, and insurance verification support. This position is responsible for managing inbound and outbound calls, coordinating patient appointments, verifying dental insurance eligibility and benefits, and ensuring accurate documentation of patient and insurance information. The representative works collaboratively with clinical, registration, and billing teams to promote efficient patient access, continuity of care, and positive patient experiences. This role may provide cross-functional support for front office and registration operations as needed to meet organizational and patient care needs.

Essential Functions

Call Center Duties

• Answer incoming calls and route inquiries to the appropriate department or individual.
• Schedule, reschedule, and cancel patient appointments in accordance with PWHS scheduling guidelines.
• Manage appointment queues including follow-ups, callbacks, and rescheduling missed appointments.
• Provide patients with general information regarding appointments, PWHS services, and processes.
• Conduct outbound calls for appointment reminders and outreach initiatives.
• Document call activity and scheduling updates accurately in the appropriate systems.
• Interact with callers in a pleasant, professional voice and provide superior customer service to both internal and external customers.
• Elevates issues to direct supervisor or their designee as appropriate
• Communicate clearly, calmly, and accurately when documenting or relaying information received by phone or in person.
• Provide coverage and support for registrar functions as operational needs require to maintain patient flow and service continuity.

Insurance Verification Duties

• Verify patient dental insurance coverage and benefits
• Call patients to review the pre-auth and schedule them
• Communicate with insurance companies to confirm eligibility, deductibles, and coverage details
• Accurately document insurance information in patient records
• Work closely with the front office team to ensure smooth patient scheduling and billing

Core Responsibilities and Organizational Expectations

In addition to role responsibilities, every employee has the following responsibilities as a part of their employment:

• Provides courteous, responsive, and service-oriented support to patients, visitors, and colleagues. Promotes a respectful and welcoming environment, communicates clearly, and works collaboratively to support team and organizational goals.
• Performs all duties in a manner consistent with Park West Health System's mission, vision, and organizational values, demonstrating a commitment to quality care, respect, and service excellence.
• Adheres to all applicable federal, state, and local regulations, as well as organizational policies and procedures, including HIPAA, privacy, and security standards.
• Follows all infection control, workplace safety, and risk management protocols. Participates in quality improvement and performance initiatives as appropriate to the role.
• Maintains professionalism, reliability, and accountability in attendance, performance, and communication; completes required trainings; participates in staff meetings and organizational initiatives
• Performs other duties on an as-needed basis.

Qualifications

Required:

• High school diploma or GED equivalent.
• Minimum of one (1) year of experience in a healthcare call center, medical office, dental office, patient access, scheduling, or customer service role.
• Experience verifying insurance eligibility, benefits, and coverage information.
• Proficiency with electronic health records (EHR) and standard office software applications.

Preferred:

• Associate degree in Healthcare Administration, Business Administration, or a related field.
• Two (2) or more years of experience in a healthcare, dental, or federally qualified health center (FQHC) environment.
• Experience with dental insurance verification, prior authorizations, and patient scheduling systems.
• Bilingual proficiency preferred.

Skills

• Ability to accurately navigate and document information within an EMR system.
• Strong customer service and telephone communication skills
• Accurate data entry and attention to detail
• Ability to manage multiple tasks and priorities
• Strong organizational and time management skills
• Professional communication and interpersonal skills
• Ability to maintain composure in a fast-paced environment