Job Details

Job Title : Claims Representative

Location : remote

In these roles you will be responsible for:

• Answering members/Providers inbound calls regarding verification of health insurance benefits, eligibility and claim status.
• Ensuring accurate and timely completion of transactions to meet or exceed Inventory level expectations.
• Resolving complex situations following pre-established guidelines for claims processing.
• Organizing and completing tasks according to assigned priorities.
• Interacting with clients and internal departments to solve issues.
• Organizing and completing tasks according to assigned priorities.
• Strong focus on quality including attention to detail, accuracy, and accountability.
• Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team.
• Multitasking and effectively navigating multiple web-based applications and other proprietary software to formulate solutions.

Requirements for this role include:

High school Diploma or equivalent.

Undergraduate degree or some college coursework preferred.

1+ year experience in customer service.

1+ years of experience that required a knowledge of healthcare insurance policy concepts.

1+ year of experience in a professional/office related role that required you to communicate (oral/written) effectively with internal team members and external customers.

1+ years of experience using a computer with Windows PC applications.

Strong analytical / problem solving skills.