Medical Claims Customer Service Representative
4 weeks ago
Telecom Inc. is seeking a highly skilled Medical Claims Customer Service Representative to join our team. As a remote Work from Home opportunity, you will be responsible for providing exceptional customer service to our clients and resolving medical claims-related issues.
Key Responsibilities:
- Receive and respond to incoming calls from providers to resolve claims-related issues
- Utilize judgment and problem-solving skills to deliver accurate information in a timely manner
- Make outbound phone calls as needed and document information as required
- Provide exceptional customer service and maintain a professional demeanor at all times
- Adjudicate and adjust medical claims against established criteria and in accordance with specific clients' SPDs
- Respond to provider inquiries on claim status, benefit designs, and claim payments
- Work collaboratively with internal teams to resolve claims-related issues
- Review vouchers and explanation of payments to identify and resolve claims-related issues
- Continually meet department performance measures related to production, accuracy, knowledge of policy and procedure, and timeliness of claims adjudication
Requirements:
- Previous medical claims processing/medical billing experience and customer service and/or call center experience, preferably in a healthcare-related or social services setting
- Knowledge of medical billing procedures, CPT, and ICD-9 coding, and medical terminology
- Proficiency with data entry skills and Microsoft Office products
- Solid organizational skills with attention to detail and follow-through
- Good written, verbal, and interpersonal communication skills
- Demonstrated ability to effectively communicate with internal and external customers
- Ability to adhere to departmental deadlines and turn-around times, to be compliant with State and Federal regulations
Benefits:
- Hiring Compensation: $18.25 per hour
- Medical/Dental/Vision
- 401(k)
- Paid Sick Time
Technical Requirements:
- USB headset with microphone
- High Speed Internet
- Computer that meets minimum technical requirements (Windows PC or Mac OS) with the latest updates and anti-virus/anti-spyware software
- Processor – 2.0 GHz Intel Pentium P4 processor or better
- Memory – minimum of 2 GB of RAM Memory
- Operating System - must be one of the following: Windows 10 Pro, Mac OS X 10.10 or newer
- No Chromebooks
- Monitor - must be capable of displaying at least 1024 X 768 pixels
Company Description:
Telecom Inc. is a leading national call center seeking experienced medical claims customer service support specialists. This is a remote Work from Home opportunity.
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