Medical Claims Processor - Health Insurance

A High-End Benefit Provider in Glendale CA. is looking to hire a Claims Customer Service Representative to oversee Medical, Dental and Vision claims while providing excellent customer service to participants, physicians, providers, and hospitals. This is a Remote position.

This role is customer facing and you will process health insurance claims and answers calls (heavy phones) while adhering to eligibility, claims and call policies and procedures while making sound claim / call decisions.

Essential Job Functions :

Ø You need efficiency, accuracy, quality, customer satisfaction and good attendance

Ø Answer incoming phone calls from customers and identify the type of assistance the customer needs (e.g. benefit and eligibility, billing and payment inquiries, authorizations for treatment and explanation of benefits (EOBs))

Ø Ask questions and listen actively to identify specific questions or issues while documenting required information

Ø Resolve problems by interpreting and clarifying issues; researching and exploring answers and alternative solutions; implementing solutions; addressing unresolved problems

Ø Review and research incoming healthcare claims by navigating multiple computer systems and platforms

Ø Ensure that the proper benefits are applied to each claim

Qualifications and Education Requirements :

Ø Bachelor’s Degree in Healthcare preferred, Math, Engineering or related field

A minimum of an Associate’s Degree required.

Ø Minimum of four (4) years of claims processing preferred

Ø Minimum of four (4) years in heavy call center required

Ø Learn various software applications and become self-sufficient in using the software in a user interface environment

Ø Demonstrate adaptability and forward-thinking

Ø Strong analytical and interpersonal skills

Ø Proficient with Microsoft products, including Word, Excel and Outlook

Ø Excellent customer service and telephone skills

Ø Ability to effectively balance workload in a fast-paced work environment

Ø Excellent verbal and written communication skills

Ø Knowledge of medical terminology

Ø Ability to research and verify claims payment, benefits, and eligibility issues

Ø Strong knowledge of benefits plans, policies and procedures

Amazing Benefits Offered

• Employer paid Medical, Dental and vision Insurance - $50 a month for Dependents up to 5 people
• 401K with 2% match
• Employees receive a Pension for Retirement!!
• Paid Parking
• Generous Vacation Pay- 12 days in first year - up to 25 days after 10 years of employment
• Sick Pay- 12 days a year
• 2 Floating Holidays
• Anniversary of your start date off every year

Reach out to Ida for all the position details at icarroll@csi4jobs.com and include your resume.

Job Type : Full-time

Pay : $55,000.00 - $62,000.00 per year

Equal Opportunity Employer considering qualified applicants in accordance with applicable state and federal laws. Qualified applicants with arrest or conviction records will be considered for employment in accordance with the LA County Fair Chance Ordinance, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance and state law.