Healthcare Claims Customer Service Representative SWHR CIN
The ideal candidate will possess the following qualifications:
Education
High School Diploma or Equivalent Required
Experience
3 years’ experience Processing Claims with a Medical Insurance Company, TPA or
HMO Required
Medicare Claims Processing
experience a plus, as well as QicLink and/or QNXT System experience Preferred
Skills
Ability to type, research and speak professionally with all callers.
Must possess knowledge of medical terminology and basic coding guidelines.
Must be detail oriented.
Must be dependable, exhibit strong initiative, and be self-motivated.
Must possess excellent communication skills.
Determine covered medical insurance losses by studying provisions of policy.
Protects operations by keeping claims information confidential.
Maintains quality customer services by following customer service practices;
responding to customer inquiries.
Respond promptly to customer inquiries.
Handle and resolve customer complaints.
Direct request and unresolved issues to the designated resource.
Record details of actions taken (phone calls).
Follow up on customer interactions.
Supervision
Individual Contributor
ADA Requirements
Working Indoors 67% or more
Physical Demands
Sedentary