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Claims Support Specialist
2 months ago
Job Type
Full-time
Position Overview
The Claims Support Specialist is essential in maintaining client satisfaction by providing exceptional customer service and addressing inquiries or challenges related to claims submissions and procedures. This role will also offer vital assistance to the Claims Department, engaging in various administrative and clerical responsibilities, including data entry, mailing, and other designated tasks. A solid understanding of claims processes and familiarity with the company's database systems are crucial for effectively supporting both internal and external stakeholders with their claims-related requirements. Success in this position relies on strong customer service, communication, and problem-solving abilities. Additionally, attention to detail, adaptability, empathy, and relevant data entry experience are key to delivering effective support to the Claims team and external clients.
Key Responsibilities
• Respond to inquiries via phone and email from both external and internal stakeholders regarding claims matters.
• Generate new tickets in the database/software systems for each incoming inquiry, tracking the issue from start to resolution.
• Conduct follow-ups for any missed communications, ensuring timely responses.
• Assist the Claims Department with claims submissions and processing tasks.
• Ensure the accuracy and quality of information entered into databases and software systems.
• Investigate database tickets and document clear, concise notes in the software/database systems.
• Compile necessary reports related to claims.
• Ensure all tickets are resolved and responded to appropriately.
• Provide data entry support and other assistance to the Claims Department as required.
• Collaborate with internal teams to ascertain the status of claims and resolve issues.
• Communicate clearly and make outbound contacts as necessary to address claims issues.
• Generate and/or run reports as requested by other internal staff.
• Undertake additional projects as assigned.
Company Overview
At Innovative Management Systems, Inc., we are seeking driven and resourceful individuals to contribute to our expanding organization. Our mission is to transform the healthcare sector by offering management and consulting services to healthcare entities, including facilities, medical groups, providers, and suppliers. Leveraging our extensive experience and comprehensive understanding of the healthcare landscape, we are committed to delivering high-quality services and customer care to our clients and their Medicare beneficiaries. By being part of IMS, you will gain valuable insights into the managed care industry and participate in the professional growth of our dynamic company.
Qualifications
Education
• High School Diploma or GED; or equivalent experience in IPA, MSO, or Health Plan environments.
Experience
• Required experience in MSO, IPA, and/or Health Plan settings.
• Familiarity with MSO operations and processes is essential.
• Proven customer service experience is necessary.
• Ability to thrive in a fast-paced environment and adapt to changing situations.
• Experience with QuickCap and/or EZ-Cap is mandatory.
• Demonstrated proficiency in accurate data entry and utilization of QuickCap and/or EZ-Cap.
Skills and Abilities
• Strong problem-resolution and attention-to-detail skills are essential.
• Proficient data entry skills; computer and technological proficiency are required.
• Capacity to learn quickly in a fast-paced administrative environment and manage calls efficiently.
• Ability to conduct ongoing audits of data as needed.
• Familiarity with MSO reporting requirements.
• Excellent customer service and communication skills.
• Strong conflict resolution and problem-solving capabilities are necessary.
• Ability to prioritize and manage multiple projects effectively.
* Please note that the 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.
Salary
$20 - $25 per hour, or depending on experience.
