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Claims Customer Service

  • Ref: 283954
  • Type: Option-to-Hire
  • Location: Pembroke Pines, FL
  • Industry: Insurance
  • Job Level: Associate
  • Pay: $13.00 - $15.00/hr.

Opportunity Description

A Claims Customer Service Representative is needed in Pembroke Pines, FL for a temporary position, with the option to hire. As The Claims Customer Service Representative, you will assist providers with inquiries specific to their medical claims.

Company Information

Our client is a licensed third party administrator that provides benefit administration services.

Job Duties

  • 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) Special projects and other duties as assigned by management. 

Education

  • High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience.

Experience & Skills Required

  • Minimum 2 years experience in medical claims environment.
  • Minimum 2 years customer service experience.
  • Strong interpersonal skills both oral and written.
  • Demonstrated knowledge of computerized medical claims processing to include claims procedures and protocols.
  • Demonstrated knowledge of workflow process.
  • Demonstrated ability to provide excellent customer service.
  • Bilingual Spanish a Plus.