The Judge Group · 18 hours ago

Customer Service Representative

United States

Full-time

Remote

Entry Level

$14/hr - $16/hr

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E-LearningInformation Technology

Hiring Manager

Kristen Hawkins

Insider Connection @The Judge Group

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Responsibilities

Responsible for functioning on a learning curve to become fully proficient in all aspects of customer service, claims and/or membership issue resolution.

Performs research and analysis, advocating on behalf of customers through whole case methods.

Learns to provide full service to members, providers, group administrators, and brokers by processing health care claims, handling inquiries, and/or performing membership functions.

Performs at least two of the three functions routinely.

Receives inbound telephone calls or paper and electronic claims from members and providers.

Resolves issues for members, providers, group administrators and brokers.

Analyzes the situation and completes research to ensure no rework or follow-up issues.

Applies knowledge of policies and procedures, products, legislation and claims workflow.

Interacts with systems to ensure claims are paid or denied based on terms of contract.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

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