Medical Claims Specialist

4 weeks ago


Lake Forest, California, United States PrideStaff Full time
Job Summary

We are seeking a highly skilled Medical Claims Specialist to join our team at PrideStaff. As a Medical Claims Specialist, you will be responsible for providing exceptional customer service to clients, policyholders, and healthcare providers.

Key Responsibilities:

  • Collaborate with clients, policyholders, and healthcare providers to resolve medical claims in a timely and accurate manner.
  • Ensure clients receive the best possible customer service experience by providing timely and accurate responses.
  • Develop and maintain effective relationships with colleagues and external partners.
  • Review, plan, and resolve medical cases in cooperation with other team members and network partners.

Requirements:

  • 1+ years of experience processing medical 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 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.


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