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Medical Insurance Customer Service Specialist
2 months ago
Position Overview:
We are looking for a skilled Medical Insurance Customer Service Specialist who possesses a solid background in managing healthcare-related inquiries. The successful candidate will demonstrate outstanding communication abilities, a comprehensive understanding of medical insurance operations, and a commitment to delivering superior customer support in a dynamic setting.
Primary Duties:
- Manage both incoming and outgoing communications regarding healthcare insurance questions, claims processing, and billing matters.
- Support patients, healthcare providers, and insurance representatives with inquiries about coverage options, benefits, and eligibility criteria.
- Accurately and efficiently process insurance claims, authorizations, and referrals.
- Address customer concerns and challenges with professionalism and compassion.
- Keep thorough and precise records of customer interactions and transactions within the system.
- Offer guidance and information on insurance policies, procedures, and relevant regulations.
- Work collaboratively with other departments to ensure effective customer service and resolution of issues.
- Stay informed about updates in insurance policies and procedures to provide reliable information to clients.
Requirements:
- Minimum of 1 year of experience in a healthcare insurance call center environment, particularly with companies such as Aetna, Blue Cross Blue Shield, UHC, or Kaiser.
- High school diploma or equivalent; an Associate's or Bachelor's degree is preferred.
- At least 2 years of experience in a call center or customer service position, focusing on healthcare insurance.
- Strong understanding of medical insurance terminology, processes, and regulations.
- Exceptional verbal and written communication skills.
- Proficient in utilizing customer service software and databases.
- Ability to handle multiple tasks and manage time effectively in a fast-paced environment.
- Strong analytical skills and attention to detail.
- Capability to work independently as well as part of a team.
- Bilingual abilities are a plus but not mandatory.
