Customer Care Analyst

The Customer Care Analyst serves as a confidential, neutral resource for members, ensuring fair treatment and helping resolve conflicts efficiently. You will manage dissatisfaction calls, grievances, exempt grievances, appeals, second opinions, and other escalated inquiries—accurately documenting each case in HSP while collaborating closely with Member Services, Grievance & Appeals, Dental Consultants, and internal partners.
 

Please note:

This is a fully remote position, but candidates must reside in Oklahoma or Florida 
Healthcare or dental industry experience is required

What You’ll Do

Member Support & Communication

• Educate members on their rights, responsibilities, and available covered dental services
• Provide clear guidance on the complaint and appeals process
• Respond to inquiries within established turnaround times (72 hours; 24 hours for emergencies)
• Compose professional and comprehensive written responses

Case Management & Documentation

• Categorize, track, and document cases accurately in HSP
• Analyze and review previous day’s call tracking for trends and corrective actions
• Collaborate with Grievance and Appeals, Compliance, Management Teams, and Dental Consultants

Operational Excellence

• Support inbound and outbound call needs
• Process emails, two‑way chat messages, and other communication channels
• Assist the call center with training, help desk support, and performance guarantees
• Ensure full compliance with corporate policies and regulatory guidelines

What Makes You Successful in This Role

• Strong communication skills—both written and verbal
• Ability to remain neutral, calm, and solution‑oriented
• Sound judgment and reasoning skills to route and resolve cases appropriately
• Commitment to handling sensitive information with confidentiality
• Drive to achieve first‑call resolution whenever possible

Education & Experience

Required

• High school diploma or GED
• Minimum 1 year of customer service experience, preferably in a call center
• Ability to pass a Florida Level 2 background check

Preferred

• Bachelor's degree
• Previous dental experience
• Experience with:
  • HSP, Meditrac, & CRM
  • Dental terminology
  • Claims/referral processing
• Conflict resolution experience

Skills You Bring

• Advanced knowledge of HSP and dental terminology
• Strong working knowledge of Microsoft Excel and Outlook
• Ability to compose clear, comprehensive written responses
• Experience in conflict resolution and escalated case handling
• Strong analytical and decision‑making skills