Medical Claims Processor

4 days ago


Foothill Ranch, California, United States PrideStaff Full time
Job Summary

We are seeking a skilled Client Services Representative to join our team at PrideStaff. As a key member of our client services team, you will be responsible for providing exceptional customer service to clients, policyholders, and healthcare providers. Your primary focus will be on assisting clients with live medical cases, providing referrals to clinics and hospitals, and ensuring timely and accurate responses to client inquiries.

Responsibilities:
  • Collaborate with clients, policyholders, and healthcare providers to resolve medical cases and provide referrals to clinics and hospitals.
  • Ensure clients receive the best possible customer service experience by providing timely and accurate responses to their inquiries.
  • Develop and maintain effective relationships with colleagues, both internal and external.
  • Review, plan, and resolve medical cases in cooperation with other team members and network partners.

Qualifications:
  • 1+ years of experience processing medical, dental, prescription, or mental health claims is a plus.
  • Must have 1+ years of customer service experience doing business-to-business customer service or experience in a medical office, healthcare, call center, or office setting analyzing and solving customer problems and billing issues.
  • Familiarity with computer and Windows PC applications, including the ability to navigate and learn new and complex computer system applications.
  • Demonstrated ability to listen skillfully, collect relevant information, build rapport, and respond to customers in a compassionate manner.
  • Proficient in translating healthcare-related jargon and complex processes into simple, step-by-step instructions that customers can understand and act upon.
  • Flexible and able to work in a fast-paced and developing environment.
  • Thrives in an environment working independently, but also collaboratively.
  • Professional phone skills required.

Compensation:
Up to $23.00 per hour.
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