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Claims Customer Service Representative

Open 56d
  • Provide claims information through telephone inquiry from providers of service.
  • Provide claim information through inquiries receive via facsimile from providers of service.
  • Recognize potential problems and refers them to the appropriate person to include Claims Management for resolution, and follows up to assure resolution.
  • Maintains a broad knowledge of all systems used in the adjudication of claims.
  • Maintains quality standards of claims calls handled.
  • Maintain a log of calls for use in the reporting and tracking of calls handled.
  • Liaison to other departments outside of the claims department.
  • Provides back-up to the Claims Department staff, (claims examiners, data entry & clerical)
  • High school diploma or general education degree (GED)
  • Minimum 5 years experience in medical claims environment.
  • Minimum 3 years customer service experience.
  • Demonstrated knowledge of ICD-9, CPT-4 and HCPCS coding
  • Fluent in both English and Spanish.

Hours for this Position:

Monday-Friday 8:30am-5:00pm

Advantages of this Opportunity:

• Competitive salary $15 - $17 per hour (depending on relevant experience)

• Right to Hire position

• Growth potential

• Fun and positive work environment


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