Health Insurance Claims Specialist
13 hours ago
We are seeking a skilled Health Insurance Claims Specialist to join our team at Apex Systems. As a key member of our customer service team, you will be responsible for providing exceptional support to our members regarding their health insurance claims.
Key Responsibilities:
- Handle inbound calls from members regarding their health insurance claims.
- Follow up with members on claim statuses, required documents, and additional information.
- Assist members in understanding their health insurance coverage and claim processes.
- Provide detailed explanations of claims decisions and necessary next steps.
- Guide members through the process of submitting claims and appeals.
- Deliver exceptional customer service by actively listening to members' needs and concerns.
- Address and resolve member inquiries in a timely and professional manner.
- Ensure members feel supported and informed throughout their claims process.
- Accurately document all client interactions in the company's CRM system.
- Prepare and maintain reports on call outcomes and client feedback.
- Follow up on unresolved issues to ensure they are addressed promptly.
Requirements:
- High school diploma or equivalent required; Associate or Bachelor's degree preferred.
- Previous experience in a call center environment, preferably in the healthcare or insurance industry.
- Strong customer service skills with the ability to effectively communicate and empathize with callers.
- Excellent problem-solving skills and attention to detail.
- Proficiency in using computer systems and navigating multiple software applications simultaneously.
- Ability to work efficiently in a fast-paced environment and manage multiple tasks effectively.
- Knowledge of health insurance terminology, claims processing procedures, and regulatory requirements is a plus.
- Flexibility to work evenings, weekends, and holidays as needed.
Equal Opportunity Employer:
Apex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law.
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