Description

The Claims Customer Support will play a role in ensuring the satisfaction of the company's clients and members by delivering outstanding customer service and resolving any inquiries or issues related to claim submissions or processes. This position will also actively support the Claims Department and provide any comprehensive support, including but not limited to administrative and clerical tasks such as mailing, data entry, and other assigned duties. Proficiency in understanding claims processes and procedures is essential, as is familiarity with the company's database system to efficiently assist both internal and external stakeholders with their claims-related needs. Success in this role hinges on possessing robust customer service, communication, and problem-solving skills. Furthermore, attention to detail, adaptability, empathy, and relevant data entry experience are all crucial in providing support to the Claims team and external stakeholders.

The Specs.

• Non-Exempt. 
• Full-Time.
• In-Office.
• Monday - Friday
• Pay Range: $20 - $25, or depending on experience.

We are an Equal Opportunity Employer and seek diversity in our workforce. We are also an E-Verify Employer, you can learn more about E-Verify program and your rights and responsibilities here: Learn More About E-Verify.

MAJOR DUTIES AND RESPONSIBILITIES

· Answer and respond to phone calls and emails from external and internal stakeholders regarding Claims issues.

· Create new tickets in the database/software systems for every incoming call from start to end of issue/inquiry.

· Conduct follow up responses or calls for any missed messages, phone calls, or emails.

· Support Claims Department in claims submissions and processes.

· Manage and ensure quality and accurate information is going into databases and software systems.

· Research and investigate database tickets and input clear, concise, and quality notes into the software/database systems.

· Assist in pulling reports needed regarding claims.

· Ensure all tickets are appropriately resolved and responded too.

· Assist in claims data entry and other support in Claims Department as needed in the Department and/or assigned by supervisor/director.

· Collaborate with internal teams to assist in finding out claims’ status and/or resolution of claims issues/inquiries.

· Clearly communicate and make outbound outreach as needed to resolve any claim issues.

· Create and/or run reports as needed by other internal staff.

· Other projects as needed and/or assigned.

Our Company

Our team at IMS is looking for highly motivated and resourceful individuals to join our growing start-up. We strive to innovate the healthcare industry by providing management and consulting services to healthcare entities, including healthcare facilities, medical groups, providers, and suppliers. Using our wide-ranging experience and comprehensive knowledge of the healthcare industry, our team works to provide quality services and customer care to our clients and their Medicare beneficiaries. By working at IMS, you’ll gain an in-depth perspective of the managed care industry and share in the professional development of our expanding company. Take initiative and ownership of your projects to make a difference and go the extra mile! We welcome you to apply to join our team!

Requirements

EDUCATION

· High School Diploma or GED; or equivalent experience in IPA, MSO, Health Plan experience.

EXPERIENCE

· Experience in MSO, IPA, and/or Health Plan experience is required.

· Understanding of MSO operations and processes is needed.

· Customer Service experience is required.

· Experience in working in a fast-paced environment and being able to adapt and be flexible to the situation present.

· Experience specifically with QuickCap and/or EZ-Cap required.

· Demonstrated experience in accurate data entry and usage of Quickap and/or EZ Cap.

SKILLS/KNOWLEDGE/ABILITIES

· Problem-resolution and attention-to-detail skills are needed.

· Strong data entry skills; computer and technological savviness are needed.

· Ability to learn quickly in a fast-paced, administrative environment, and handle calls quickly and efficiently.

· Ability to continuously audit data at any given time.

· Familiarity with MSO reporting needs.

· Strong customer service and communication skills.

· Strong Conflict Resolution and problem-solving skills are needed.

· Ability to multi-task and prioritize priority projects.

*Please note that the duties and responsibilities outlined above are summarized and may not encompass all tasks associated with the position. The nature of the role may require adaptation to changing circumstances and additional responsibilities not explicitly mentioned here. The organization reserves the right to modify, interpret, or supplement the job duties as needed.