Claims Service Support Specialist

2 weeks ago

Toledo, Ohio, United States Innovative Management Systems Incorporated Full time
Job Title: Claims Service Support

The Claims Service Support role is a critical position within our organization, responsible for ensuring the satisfaction of our clients and members by delivering exceptional customer service and resolving any inquiries or issues related to claim submissions or processes.

This position will actively support the Claims Department and provide comprehensive support, including administrative and clerical tasks such as mailing, data entry, and other assigned duties. Proficiency in understanding claims processes and procedures is essential, as is familiarity with our database system to efficiently assist both internal and external stakeholders with their claims-related needs.

Success in this role hinges on possessing robust customer service, communication, and problem-solving skills. Furthermore, attention to detail, adaptability, empathy, and relevant data entry experience are all crucial in providing support to the Claims team and external stakeholders.

Key Responsibilities:
  • Answer and respond to phone calls and emails from external and internal stakeholders regarding Claims issues.
  • Create new tickets in the database/software systems for every incoming call from start to end of issue/inquiry.
  • Conduct follow-up responses or calls for any missed messages, phone calls, or emails.
  • Support Claims Department in claims submissions and processes.
  • Manage and ensure quality and accurate information is going into databases and software systems.
  • Research and investigate database tickets and input clear, concise, and quality notes into the software/database systems.
  • Assist in pulling reports needed regarding claims.
  • Ensure all tickets are appropriately resolved and responded to.
  • Assist in claims data entry and other support in Claims Department as needed in the Department and/or assigned by supervisor/director.
  • Collaborate with internal teams to assist in finding out claims' status and/or resolution of claims issues/inquiries.
  • Clearly communicate and make outbound outreach as needed to resolve any claim issues.
  • Create and/or run reports as needed by other internal staff.
  • Other projects as needed and/or assigned.
Requirements:
  • High School Diploma or GED; or equivalent experience in IPA, MSO, Health Plan experience.
  • Experience in MSO, IPA, and/or Health Plan experience is required.
  • Understanding of MSO operations and processes is needed.
  • Customer Service experience is required.
  • Experience in working in a fast-paced environment and being able to adapt and be flexible to the situation present.
  • Experience specifically with QuickCap and/or EZ-Cap required.
  • Demonstrated experience in accurate data entry and usage of Quickap and/or EZ Cap.
Skills/Knowledge/Abilities:
  • Problem-resolution and attention-to-detail skills are needed.
  • Strong data entry skills; computer and technological savviness are needed.
  • Ability to learn quickly in a fast-paced, administrative environment, and handle calls quickly and efficiently.
  • Ability to continuously audit data at any given time.
  • Familiarity with MSO reporting needs.
  • Strong customer service and communication skills.
  • Strong Conflict Resolution and problem-solving skills are needed.
  • Ability to multi-task and prioritize priority projects.

Please note that the duties and responsibilities outlined above are summarized and may not encompass all tasks associated with the position. The nature of the role may require adaptation to changing circumstances and additional responsibilities not explicitly mentioned here. The organization reserves the right to modify, interpret, or supplement the job duties as needed.

Compensation: $20-$25 hourly wage

  • Insurance Claims Specialist

    5 days ago

    Toledo, Ohio, United States Toledo Clinic Full time

    Toledo Clinic is seeking a skilled Insurance Claims Specialist to join our team. As an Insurance Claims Specialist, you will play a critical role in ensuring the smooth processing of patient insurance claims. Your primary responsibilities will include verifying patient insurance information, filing insurance claims, processing payments and adjustments, and...

  • Technical Claims Specialist

    3 weeks ago

    Toledo, Ohio, United States VirtualVocations Full time

    Technical Claims Specialist **Job Summary:** VirtualVocations is seeking a highly skilled Technical Claims Specialist to join our team. As a Technical Claims Specialist, you will provide technical oversight to high-risk and complex workers compensation claims. Your expertise will be essential in serving as the primary point of contact for critical national...

  • Warranty Claims Specialist

    3 weeks ago

    Toledo, Ohio, United States VirtualVocations Full time

    Warranty Administrator Job Description **Key Responsibilities:** * Prepare, submit, and track warranty claims accurately and timely * Review warranty repair orders and communicate with service advisors * Maintain positive relationships with service and parts departments **Required Qualifications:** * High school diploma or equivalent * 1+ years of...

  • Claims Examiner II/III

    2 weeks ago

    Toledo, Ohio, United States Innovative Management Systems Incorporated Full time

    Job Title: Claims Examiner II/IIIInnovative Management Systems Incorporated is seeking a highly skilled Claims Examiner II/III to join our team. As a Claims Examiner II/III, you will be responsible for accurately reviewing, researching, and analyzing professional claims for a managed service organization (MSO).Key Responsibilities:Identify authorizations and...

  • Insurance Claims Processor

    1 week ago

    Toledo, Ohio, United States Toledo Clinic Full time

    Job SummaryWe are seeking a highly organized and detail-oriented Insurance Claims Processor to join our team at Toledo Clinic. As an Insurance Claims Processor, you will be responsible for verifying patient insurance information, filing insurance claims, and processing payments and adjustments.Key ResponsibilitiesVerify patient insurance information and file...

  • Claims Examiner II/III

    1 week ago

    Toledo, Ohio, United States Innovative Management Systems Incorporated Full time

    Job SummaryWe are seeking a highly skilled Claims Examiner II/III to join our team at Innovative Management Systems Incorporated. This is a challenging role that requires a strong understanding of Medicare claims processing, particularly in managed care organizations, managed service organizations, IPAs, and health plans.Key Responsibilities:Accurately...

  • Claims Examiner II/III

    1 week ago

    Toledo, Ohio, United States Innovative Management Systems Incorporated Full time

    Job Title: Claims Examiner II/IIIWe are seeking a highly skilled Claims Examiner II/III to join our team at Innovative Management Systems Incorporated. This is a challenging and rewarding role that requires a strong understanding of Medicare claims processing and a keen eye for detail.Key Responsibilities:Accurately review and analyze professional claims for...

  • Claims Examiner II/III

    5 days ago

    Toledo, Ohio, United States Innovative Management Systems Incorporated Full time

    Job Title: Claims Examiner II/IIIWe are seeking a highly skilled Claims Examiner II/III to join our team at Innovative Management Systems Incorporated. This is a challenging and rewarding role that requires a strong understanding of Medicare claims processing and a keen eye for detail.Key Responsibilities:Accurately review and analyze professional claims for...

  • Physical Therapist

    3 weeks ago

    Toledo, Ohio, United States Healthcare Support Full time

    Healthcare Support is seeking a Physical Therapist for a travel job in Toledo, Ohio.**Job Details:*** Specialty: Physical Therapist* Discipline: Therapy* Employment Type: Travel* Duration: 13 weeks* Hours per week: 40* Shift: 8 hours**Benefits:*** Immediate enrollment in Health Insurance* Dental Insurance* Life Insurance* Employee Assistance Program (EAP)*...

  • Travel Nurse ICU Specialist

    2 weeks ago

    Toledo, Ohio, United States Healthcare Support Full time

    Job Title: Travel Nurse ICU SpecialistHealthcare Support is seeking a skilled Travel Nurse ICU Specialist to join their team in Toledo, Ohio.Job Description & RequirementsSpecialty: ICU - Intensive Care UnitDiscipline: RNEmployment Type: TravelPerks: Up to $500 travel reimbursement, overtime and loyalty bonuses, license and certification reimbursements,...

  • Travel Nurse ICU Specialist

    3 weeks ago

    Toledo, Ohio, United States Healthcare Support Full time

    Job Title: Travel Nurse ICU SpecialistHealthcare Support is seeking a skilled Travel Nurse ICU Specialist to join their team in Toledo, Ohio.Job Description & RequirementsSpecialty: ICU - Intensive Care UnitDiscipline: RNEmployment Type: TravelPerks: Up to $500 travel reimbursement, overtime and loyalty bonuses, license and certification reimbursements,...

  • Traveling Electrophysiology Specialist

    4 weeks ago

    Toledo, Ohio, United States Healthcare Support Full time

    Healthcare Support is currently in search of a traveling Electrophysiology Specialist for an exciting opportunity. Position Overview & Requirements Specialty: Electrophysiology Specialist Discipline: Allied Health Professional Duration: 13 weeks36 hours per week Shift: 9 hours, daytime Employment Type: Travel Benefits: 4 shifts of 9 hours each, from 7:30 AM...

  • Travel Nurse RN Specialist

    4 weeks ago

    Toledo, Ohio, United States Healthcare Support Full time

    Job Title: Travel Nurse RN SpecialistJob Summary:Healthcare Support is seeking a skilled Travel Nurse RN Specialist to join our team in a dynamic Operating Room environment. As a key member of our healthcare team, you will provide high-quality patient care and support to our clients.Key Responsibilities:Provide exceptional patient care and support in a...

  • Travel Nurse RN Specialist

    4 weeks ago

    Toledo, Ohio, United States Healthcare Support Full time

    Job Opportunity with Healthcare SupportJob Title: Travel Nurse RN SpecialistJob Summary: Healthcare Support is seeking a skilled Travel Nurse RN Specialist to join our team in a Cardiac Cath Lab setting.Responsibilities:Provide high-quality patient care in a Cardiac Cath Lab environmentCollaborate with healthcare professionals to ensure seamless patient...

  • Support Services Coordinator

    2 weeks ago

    Toledo, Ohio, United States Harbor, Inc. Full time

    Job SummaryHarbor, Inc. is seeking a highly skilled Support Services Specialist to provide exceptional front desk support in a fast-paced environment.Key Responsibilities:Provide warm, courteous, and efficient customer service to clients via phone and in-person.Schedule appointments, manage client records, and maintain accurate data entry.Collect payments,...

  • Customer Account Specialist

    2 weeks ago

    Toledo, Ohio, United States Harbor, Inc. Full time

    Job Title: Customer Account SpecialistHarbor, Inc. is seeking a highly skilled Customer Account Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for ensuring accurate and timely billing and insurance processing for our clients.Key Responsibilities:Verify insurance coverage and co-payments for clientsUpdate...

  • Computer Support Specialist

    2 days ago

    Toledo, Ohio, United States Nemsys Full time

    Job OverviewNemsys is seeking a skilled Computer Support Specialist to join our team. As a key member of our support team, you will be responsible for delivering timely, accurate, and reliable support to our partner clients.As a Computer Support Specialist, you will serve as the foundation for delivering exceptional support services. Your primary...

  • IT Support Specialist

    2 weeks ago

    Toledo, Ohio, United States America Chung Nam Full time

    Job Title: Junior IT Support SpecialistWe are seeking a highly motivated and detail-oriented Junior IT Support Specialist to join our team at America Chung Nam. As a key member of our IT department, you will be responsible for providing technical support to our employees, ensuring the smooth operation of our office systems, and contributing to the overall...

  • Technical Support Specialist

    3 weeks ago

    Toledo, Ohio, United States Dave & Buster Full time

    Job SummaryWe are seeking a highly skilled and motivated Technical Support Specialist to join our team at Dave & Buster's. As a Technical Support Specialist, you will be responsible for the repair and maintenance of our building's technical equipment, including games, simulators, and other technical systems.Key ResponsibilitiesRepair and maintain technical...

  • IT Support Specialist

    2 weeks ago

    Toledo, Ohio, United States Comprehensive Data Services Inc Full time

    Job OverviewWe are seeking a highly skilled and experienced IT Support Specialist to join our team at Comprehensive Data Services Inc. As a key member of our technical support team, you will be responsible for providing top-notch technical assistance to our clients, ensuring their computer and VoIP systems are running smoothly and efficiently.Key...