Insurance Claims Specialist

4 weeks ago


Louisville, Kentucky, United States Randstad Full time

Randstad is currently recruiting for an Insurance Customer Service Representative position. This is a temporary to hire opportunity that is 100% in-office. The position is located in the East End of Louisville and requires a Monday-Friday schedule from 8am-5pm. To be eligible, candidates must have a High School Diploma and at least 3 years of call center or customer service experience. They must also be able to work independently.

  • Respond to inquiries regarding eligibility, benefits, claims status, provider status, membership, and billing from various stakeholders, including subscribers, providers, group administrators, and agents/brokers.
  • Document each customer interaction thoroughly in the ETS system.
  • Research and correct claims processed incorrectly; process claim adjustments and issue refunds as necessary.
  • Participate in ongoing training programs and provide support to other departments as required.
  • Identify, report, and document system discrepancies to management for resolution.
  • Maintain a positive and professional attitude when interacting with both internal and external customers, ensuring high-quality customer service.
  • Protect all private health information in accordance with HIPAA guidelines.
  • Handle escalated customer inquiries when management or team leads are unavailable.
  • Perform other related duties as needed to support the primary job responsibilities.

Key Skills:

  • Medical Health Benefits
  • Insurance
  • Microsoft Excel
  • Analytical Thinking
  • Data Entry
  • Administrative Duties
  • Health Insurance Policies
  • Insurance Claim Processing
  • Customer Service

Requirements:

  • Years of experience: 3 years
  • Experience level: Experienced

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

Equal Opportunity Employer: Randstad is an equal opportunity employer and welcomes people of all abilities. We want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact us.

Pay and Benefits: Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including health, an incentive and recognition program, and 401K contribution (all benefits are based on eligibility).



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