Medical Claims - Healthcare Customer Service

Work for a growing Full-function 3rd Party Administrator that processes payments for thousands of individuals nationally. These volume transactions are associated with healthcare benefits, and medical payments that include deductibles and co-payments for medical and pharmaceutical claims.

Monday through Friday: 11:30am - 8:00pm with 2 days 9:30am to 6:00pm
Starting pay rate $22/hr

Job Responsibilities:

Resolve client health premiums and out of pocket medical expenses by reviewing medical documentation and looking at gaps in medical documentation or records that could help with payment guidelines.

A representative list of duties:

• Answer phones and respond to client inquiries related to payments made on their behalf.
• Make outgoing calls to clients, medical providers, insurance companies to resolve coding, payment, billing issues.
• Identify, research and resolve client issues.
• Ensure payment processing timeliness and accuracy are met.
• Send follow up letters approval and denial letters.
• Uses knowledge of Medicare, Medicaid and commercial insurance along with primary and secondary insurance claims.
• Process health and dental insurance premium payments for clients.

Required Skills:

• Associate’s Degree preferred
• Experience with Medical Insurance including- Insurance follow up / Medical billing and payment / Billing resolution/ Insurance Claims
• Good understanding of Medicare, Medicaid, commercial insurance and secondary insurance
• Ability to read and understand missing Clinical Documentation, Clinical coding Enrollment; and Payment Terms related to insurance premiums and out of pocket expenses; Benefits Coordination with other insurance coverage.
• STRONG COMMUNICATION SKILLS–This is a highly interactive role . The chosen candidate will have experience with customer service, call center experience from an Insurance, billing or medical processing payment environment.
• Technology and Computer Skills: Proficiency with all MS Office applications (Excel, Word, Outlook, etc.) Billing and Insurance Software

This role is in a very nice office building that is easy to access with Free onsite parking.

INDH