Health Insurance Call Center Specialist
4 days ago
We are a leading provider of comprehensive administrative solutions for the insurance industry. Our team is dedicated to delivering exceptional customer service, efficient processing, and quality results. We believe in the importance of teamwork and provide a collaborative environment where our employees can excel.
Job Summary
As an Insurance Claims Adjudicator, you will be responsible for examining, researching, and making decisions to properly adjudicate telephone and written inquiries. You will interpret contract benefits in accordance with specific claims processing guidelines and communicate problems identified relevant to the claims processing system to the appropriate people. You will also receive, organize, and make daily use of information regarding benefits, contract coverage, and policy decisions. Your primary responsibilities will include:
- Interpreting contract benefits accurately to policyholders, agents, and providers.
- Providing claim status to policyholders or providers.
- Sending out refund request letters and following up as necessary.
- Producing correspondence to customers.
- Answering calls in a helpful, professional, and timely manner.
- Placing outgoing calls to provide or obtain information.
- Documenting all calls while in progress.
- Transferring calls to employees in other departments as required.
- Fully documenting policy files or imaging systems with all related material.
- Actively participating in cross-training and group training sessions to maximize team efficiency and maintain or exceed service standards.
- Communicating openly with supervisors, team leads, and other team members to ensure accurate responses and avoid duplication of efforts.
Requirements
We are seeking a highly motivated and detail-oriented individual with a minimum of one year of related experience in a fast-paced call center environment. Experience in medical or insurance is preferred, as is experience with Medicare Supplement. You must be local or residing in the nearby area. We offer a competitive compensation package, including benefits that make work more fun and give you and your family peace of mind. Join our team and start a career in a family-like environment that is rewarding and cutting edge. We celebrate your hard work and support you daily. Joining us means being part of a hyper-growth company with tons of professional opportunities for you to accelerate your career. We are an Equal Opportunity employer and provide reasonable accommodations for qualified individuals with disabilities.
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