Florida Blue · 4 months ago
Client Resolution Specialist
Irving, TX, United States
Full-time
Onsite
Entry Level
1+ years expFlorida Blue is a healthcare company committed to providing quality service. They are seeking a Client Resolution Specialist to handle inbound customer calls, focusing on resolving client-related issues and providing expert-level resolution to complex cases.
ConsultingHealth CareInsurance
Responsibilities
Primary client contact for claims and customer service issues and question for assigned accounts. Main customer service contact to resolve issues and identify customer needs on a pro-active basis
Utilize systems to tract all assigned clients questions or concerns
Assisting with customer service phone calls and queues as assigned
Identify members who have high claim volumes or excessive calls to customer service, which may be an indication that they need help understanding their plan or help with finding solutions
Work directly with the Benefit Consultant for the employer group, to resolve claim or customer service issues
Other responsibilities include researching claim appeals, researching benefit questions, locating in-network providers
Provide instruction and training to Customer Service Team when directed by the employer group or the Customer Service Manager
Assisting with assigned special projects
Qualification
Required
1+ years related work experience in customer service
High school diploma or GED
Knowledge of CPT and ICD-9 coding, COBRA, HIPAA, pre-existing conditions, and coordination of benefits
Data entry and 10-key by touch/sight required
Concise written and oral communication skills required, including the ability to deal with conflict
Proficiency in maintaining good rapport with physicians, healthcare facilities, clients and providers
Knowledge of all MS Office products
Must possess proven judgment, decision-making skills and the ability to analyze
Preferred
Some college courses in related field
Other experience in customer service for all types of medical claims would be helpful
Proficiency and experience in WebTPA systems
Company
Florida Blue
Florida Blue is a subsidiary of a not-for-profit health solutions company dedicated to serving all Floridians in the pursuit of health.
5001-10000 employees
H1B Sponsorship
Florida Blue has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (33)
2024 (27)
2023 (33)
2022 (20)
2021 (38)
2020 (56)
Funding
Current Stage
Late StageLeadership Team
Patrick Geraghty
President and CEO
Recent News
2025-11-04
Company data provided by crunchbase