Telephone Inquiry Specialist

* Researches, resolves and responds to complex telephone inquiries that cannot be answered immediately by the Toll Free Telephone Representative and monitors cycle time reports. Processes in-house documents-CIFs, NOAs, Claims, TARs and RTDs.
* Responds to incoming calls from Medi-Cal dental Beneficiaries and/or their representatives concerning general program policies, regional screening appointments, Treatment Authorization Request (TAR) Notifications, complaints; refers callers to Denti- Cal providers; reschedules regional screening appointments; refers callers to other agencies or resources. Tracks call information in the Beneficiary Correspondence Tracking System.
* Responds to incoming calls from Denti-Cal provider offices regarding program policies/procedures, claims/TARs processing, EOB and check inquiries; provides patient history information and office enrollment status. Tracks call information in the Provider Correspondence Tracking System.
* Miscellaneous projects as assigned.

Skills/Experience:
Job Requirements:

* Dental Assisting Certificate from an accredited dental assisting school and/or a minimum of two years dental assisting experience in a dental office.
* Pass DDC Dental Auditor V test and x-ray reading test.
* One year communication experience.
* Must be able to work regular overtime as required.
* Knowledge of Denti-Cal provider billing procedures and claims adjudication processes
* Medi-Cal rules and regulations, dental codes, procedures and practices preferred
* Skills in communication, problem solving, basic math and use of computer tools.
* Knowledge of dental anatomy, physiology, pathology and nomenclature used in the dental office.
* Ability to handle detailed work.
* Ability to maintain confidentiality.
* Ability to handle multiple concurrent tasks.
* Customer contact skills.
* Ability to handle constant interruptions.
* Stress management skills.
* Reasoning skills.