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Claims Customer Service Representative

Fort Lauderdale, FL, United StatesRemoteFull-time

AI Summary

Handles inbound and outbound telephone inquiries related to healthcare claims, resolves issues, coordinates with claims management, and supports claims department operations.

About this role

Claims Customer Service Representative

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

  • Provide claims information through telephone inquiry from providers of service.
  • Provide claim information through inquiries receive via facsimile from providers of service.
  • Recognize potential problems and refers them to the appropriate person to include Claims Management for resolution, and follows up to assure resolution.
  • Maintains a broad knowledge of all systems used in the adjudication of claims.
  • Maintains quality standards of claims calls handled.
  • Maintain a log of calls for use in the reporting and tracking of calls handled.
  • Liaison to other departments outside of the claims department.
  • Provides back-up to the Claims Department staff, (claims examiners, data entry & clerical)

Qualifications

  • High school diploma or general education degree (GED)
  • Minimum 5 years experience in medical claims environment.
  • Minimum 3 years customer service experience.
  • Demonstrated knowledge of ICD-9, CPT-4 and HCPCS coding
  • Fluent in both English and Spanish.

Additional Information

Hours for this Position:

Monday-Friday 8:30am-5:00pm

Advantages of this Opportunity:

• Competitive salary $15 - $17 per hour (depending on relevant experience)

• Right to Hire position

• Growth potential

• Fun and positive work environment


Skills

Claims Adjudication SystemsCPT-4Customer ServiceHCPCSICD-9Medical Claims

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