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Medicare Claim Representative

4 months ago


Brookhaven, United States OneSparQ Full time

OneSparQ is looking for a Customer Service Representative for a health and life insurance provider in Brookhaven, GA.


Required Skills:

  • 1+ years of experience within Medicare Claims adjudication
  • 1+ years of experience working in a call center environment with a one call mindest
  • Proficiency with Microsoft Suite of products


Additional Skills:

  • Experience with Claims Adjudication and EOB
  • Familiarity with the Medicare Supplement Process


Responsibilities:

  • Handle inbound calls from customers regarding health insurance claims
  • Provide accurate information about claim status, policy coverage, and benefits
  • Assist customers in filing health insurance claims and guide them through the process
  • Document all customer interactions and transactions, recording details of inquiries, complaints, and comments, as well as actions taken
  • Coordinate with the claims department to resolve customer issues
  • Maintain customer confidentiality and adhere to health privacy regulations
  • Participate in training sessions to stay updated with the latest industry regulations and practices