Insurance Claims Specialist

2 days ago


Charleston, West Virginia, United States Encova Insurance Full time
Job Summary

The Engagement Center Representative provides exceptional customer service to clients by addressing their inquiries and concerns related to claims, medical billing, and policy information. This role involves interacting with customers via phone, email, or chat to resolve their issues and provide accurate information.

Key Responsibilities
  • Provide general or specific information to customers regarding claims, medical billing, or policy-related questions.
  • Analyze customer information to determine the nature of their inquiry and take appropriate action.
  • Interact with other associates to answer questions, provide support, or assist in problem resolution.
  • Create certificates of insurance for policyholders and enter or update specific claim, policy, and customer data into the computer system.
  • Research medical bill coding issues or pharmacy-related issues and provide support to customers and agents.
  • Utilize the Encova Edge Portal to provide support to customers and agents.
Requirements
  • Ability to provide excellent customer service to both external and internal customers.
  • Ability to work as a team member and perform based on established standards and expectations.
  • Ability to multi-task and be detail-oriented.
  • Excellent written and oral communication skills.
  • Experience with Microsoft Products.
  • Ability to utilize critical thinking skills and work proficiently in multiple systems.
  • Ability to consistently exercise sound judgment and effectively analyze and apply information.
What We Offer

At Encova Insurance, we value our associates and strive to provide a work environment that offers challenging, stimulating, and financially rewarding opportunities. We offer a competitive salary, bonus, and benefits package, including a 401(k), wellness programs, bonus incentive plans, and flexible schedules. Additionally, we encourage and support associate participation in community initiatives through our foundations.

Encova Insurance is an EOE/E-Verify employer.


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