Client Service Rep
- A Claims Associate researches and resolves medical claims questions. It's a great role for learning a lifelong skill in understanding health benefits. This is an entry level role in which we will train you to understand Health Benefit Plans, claims processing guidelines and health coding practices.
- This role is a great way to learn about medical plans and enhance your career in the health benefits field.
- The role is comprised of detailed investigations in which you will look at how a medical claim should be processed and resolve it for our member if it was incorrectly adjudicated initially.
??? Handle cases in a timely manner to identify opportunities to resolve the issue by working with plan documents, carriers, providers and member.
??? Research plan information and identify where there may be conflicting information. Escalate as needed to supervisor or other levels of management for clarification and assistance.
??? Research billing issues to determine the possible cause of the error, and assisting with claims resubmission when needed to correct the issue.
??? Heavily working with these resources to analyze and resolve billing issues:
o Plan documents and plan benefits
o Interpretation of benefits
o Medical, dental, vision, behavioral health billing and claims adjudication
o FSA, HRA and HSA plans
Working hours: 8:00 AM - 6:00 PM
Minimum of one year healthcare or benefits experience
Minimum one year customer service, healthcare, or employee benefits experience
??? High School Degree or GED required
??? Time spent in pursuit of a Bachelor???s degree (e.g. Junior and Senior year) may be substituted in lieu of experience requirements
??? Associate degree preferred
??? Minimum of three years customer service, healthcare, or claims experience required
Please apply to this job and email your resume to firstname.lastname@example.org
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