Join the #1 company in New York's dental insurance market! Healthplex offers excellent career opportunities in an organization that provides career advancement and training programs while recognizing and rewarding strong performance. We offer competitive compensation and benefits packages and new executive management is dedicating time and resources to making Healthplex the best place to work on Long Island.

Current Career Opportunities

Bilingual Customer Service Representative

Position Title:

Bilingual Customer Service Representative

Reports To:

Director of Customer Service

FLSA Status:

Full Time

Summary:

A Bilingual Customer Service Representative must be able to speak/read/write in English as well as one of the following: Spanish, Russian, Mandarin, or Cantonese. A Bilingual Customer Service Representative assists our members in an inbound call center by investigating and responding to all member inquiries regarding dental plan coverage, status of claims, provider information, and any other information that will assist our members. Customer Service Representatives are full time employees scheduled for 35 hours a week. We are currently looking to fill positions for Monday-Friday from 10:30am to 6:00pm. Paid training will be the first seven business days of employment from 9:00am to 4:30pm.

Essential Duties and Responsibilities:

Include the following. Position Description may change as business conditions change.
Efficiently answer inbound calls while resolving member issues concerning their dental coverage
Handle irate customers in a professional manner
Adhere to all attendance/punctuality policies and procedures
Absorb and retain information to ensure consistency when explaining benefits, regulatory items, and policy and procedures
Meet or exceed standards of quality and professionalism as set by both Healthplex and the NCQA
Provide professional and courteous service to all lines of business
Ensure consistency and adherence to departmental work flows, policy and procedures
Follow appropriate avenues of protocol to elevate issues
Input comments regarding customer issue and relative data into the database
Call customers when necessary to advise on next steps and/or inform of resolution
Obtain customer feedback information and multi task while on the phone

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education And/Or Experience:

High School diploma or GED. Preferred Experience: 1 year of Customer Service Call Center experience. Experience working in Dental Office and/or HMO/Insurance

Computer Skills:

Basic computer skills as well as quick and accurate typing skills.

Other Skills:

Fluent (speak/read/write) in English as well as Spanish, Russian, Mandarin, or Cantonese. Excellent communication skills (good grammer, voice, and diction). Excellent customer service skills (friendly, courteous, and helpful).

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Clinical Reviewer (Licensed Dentist)

Position Title:

Clinical Reviewer (Licensed Dentist)

Reports To:

Director of Utilization Management

FLSA Status:

Non-Exempt, Part-Time

Summary:

The primary function of the Clinical Reviewer is to review dental claim forms, treatment plans and other documents relating to the provision of dental services and impose, wherever applicable, the exclusions and limitations of the Companys dental benefit plans.

Essential Duties and Responsibilities:

Include the following. Position Description may change as business conditions change.
Review documents submitted by managed care and fee-for-service dentists in the manner set forth in the Companys policies.
Respond on a timely basis to inquiries from staff members regarding the provision of services to enrollees.
If requested, to participate as a member of the Quality Improvement Committee.
If requested, to participate as a member of the Utilization Review Committee.
If requested, to participate as a member of the Complaint and Appeals Review Committee.

Qualifications:

Licensed as a dentist under the laws of the State of New York, authorized to practice dentistry and currently approved by the Department of Education of the State of New York
or;
Licensed as a dentist under the laws of the State of New Jersey, authorized to practice dentistry and currently approved by the Department of Law & Public Safety, Division of Consumer Affairs of the State of New Jersey.
Have no history of any Medicaid/Medicare and/or other governmental regulatory sanctions.
Be properly credentialed by a Credentials Verification Organization.
Maintain a knowledge of current dental procedures, terminology and treatment codes.

Education And/Or Experience:

Be a graduate of an accredited dental school.
Have a minimum of ten (10) years experience in the dental field.

Computer Skills:

Other Skills:

All qualified applicants will receive consideration for employment without regard to age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, nationality or sex.

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Credentialing Assistant

Position Title:

Credentialing Assistant

Reports To:

Director of Credentialing - Healthplex, Inc.

FLSA Status:

Non-Exempt, Non-Union

Summary:

A Credentialing Assistant processes provider information as directed and provides general administrative support to the Credentialing department.

Essential Duties and Responsibilities:

Include the following. Position Description may change as business conditions change.
Performs application data entry with strong attention to detail.
Handles follow-up phone calls to providers.
Primary source verification for state licenses, DEA certificates, malpractice insurance and sanctions
Mailing of provider applications.
Filing and scanning of provider information.

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education And/Or Experience:

High school diploma or GED

Computer Skills:

Basic computer skills. Familiarity with a keyboard. Excellent verbal communication skills and phone etiquette.

Other Skills:

All qualified applicants will receive consideration for employment without regard to age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, nationality or sex.

Apply Now

Data Entry Processor

Position Title:

Data Entry Processor

Reports To:

Claims Manager

FLSA Status:

Union; Non-Exempt; Full-Time

Summary:

A Data Entry Technician in the Claims Department is responsible for accurately entering data from claim forms.

Essential Duties and Responsibilities:

Include the following. Position Description may change as business conditions change.
Accurately enter high volume of dental claims data into company database.

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education And/Or Experience:

High school diploma or GED

Computer Skills:

Strong Data Entry Skills. Minimum data entry speed of 10,000 + keystrokes per hour required.

Other Skills:

Punctual, reliable, strong attention to detail skills required. All qualified applicants will receive consideration for employment without regard to age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, nationality or sex.

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Receptionist Front Desk Corporate Office

Position Title:

Receptionist Front Desk Corporate Office

Reports To:

Manager of Operations

FLSA Status:

Non-Exempt

Summary:

A Receptionist welcomes visitors and callers by greeting them with a pleasant and professional demeanor. Performs a variety of clerical receptionist duties and maintains security by following corporate procedures.

Essential Duties and Responsibilities:

Include the following. Position Description may change as business conditions change.
Greet and welcome visitors and callers in a professional and courteous manner.
Promptly and accurately direct all incoming calls from a multi-line switchboard.
Responsible for maintaining a neat appearance in the vestibule, including but not limited to an organized workspace, proper inventory of all supplies and forms.
The Receptionist must immediately elevate vestibule safety and security risks to management.
Sort incoming mail by department and make a corporate announcement for department pick up daily.
Follow proper protocol to validate, log in and assign passes to all appropriate visitors.
Ability to organize, multitask and prioritize.
Ability to be resourceful and proactive in dealing with issues that may arise.
Punctual and reliable.

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education And/Or Experience:

High school diploma or GED. One to two years clerical/switchboard experience.

Computer Skills:

Proficient with Microsoft Office Suite, Outlook, Word and Excel.

Other Skills:

Strong organization skills. Solid communication skills both written, verbal and customer service skills. Must be a team player with the ability to interact well at all levels. Professional appearance at all times.

Apply Now

Equal Employment Opportunity:

Healthplex is committed to equal employment opportunities. It is Healthplex's policy to prohibit employment discrimination, including but not limited to harassment on the basis of age, ancestry, color, marital status, (including civil union status), national origin, race, religious creed, sex, sexual orientation, disability, veteran status, citizenship status or any other characteristic protected by law.