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Supplemental Health Claims CSR (Remote)

Supplemental Health Claims CSR (Remote)

Las Vegas StaffingLas Vegas, NV, US
6 hours ago
Job type
  • Full-time
  • Remote
Job description

Job Title

Provide call center callers with timely, accurate, and customer-focused claim information, solicit information needed to perfect the claim, consistently deliver a superior level of customer service, document the claim system, work with the Supplemental Health and Limited Medical Benefit products, and perform well in a call center team environment.

Required Skills & Abilities :

  • Experience : Minimum of 2 years of experience in a call center environment, within the health insurance / medical claims industry.
  • Knowledge : Strong understanding of health insurance claims and benefits. Particularly Scheduled Accident, Critical Illness, and Hospital Indemnity plans preferred.
  • Knowledge of HFCA 1500 & UB04 forms
  • Ability to recognize CPT & revenue cycle codes.
  • Must have a high school diploma or GED.
  • Proficiency in MS Office applications

Key Responsibilities :

  • Customer Service Calls : Provide customers with timely, accurate, and customer-focused benefit and claim information.
  • Solicit and enter the information needed to enter and process claims accurately and in a timely manner.
  • Record summaries of information exchanged in our claim system with a high level of accuracy and detail easily understood by the user.
  • Issue timely and accurate claim acknowledgement correspondence.
  • Process incoming documents with high coding integrity and distribute immediately.
  • Remain fully compliant with operational standards.
  • Meet or exceed call center operational metrics.
  • Claims Registration : Enter incoming claims information with a high degree of accuracy, meeting or exceeding established metrics.
  • Comprehensively review and evaluate appeal and complaint requests to identify and classify member and provider appeals.
  • Determine eligibility, benefits, and prior activity related to the claims, payment, or service in question.
  • Research appeal files for completeness and accuracy and investigate deficiencies.
  • Details :

  • 100% Remote | Equipment Provided. Applicants must provide the internet and a quiet workspace.
  • Schedule : Monday to Friday | 8 : 30am 5 : 00pm (PST). (45-minute lunch break, 38.5 hours per week)
  • Pay : $20 - $22 / hr.
  • Pay cycle Weekly | Medical, Dental & Vision Benefits offered.
  • Workplace Type : This is a fully remote position.

    Application Deadline : This position is anticipated to close on Nov 7, 2025.

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    Csr • Las Vegas, NV, US

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