Claims Customer Service
Pembroke Pines, FL
- Job Level:
$13.00 - $15.00/hr.
A Claims Customer Service Representative is needed in Pembroke Pines, FL for a temporary position, with the option to hire. As The Claims Customer Service Representative, you will assist providers with inquiries specific to their medical claims.
Our client is a licensed third party administrator that provides benefit administration services.
- Provide claims information through telephone inquiry from providers of service.
- Provide claim information through inquiries receive via facsimile from providers of service.
- Recognize potential problems and refers them to the appropriate person to include Claims Management for resolution, and follows up to assure resolution.
- Maintains a broad knowledge of all systems used in the adjudication of claims.
- Maintains quality standards of claims calls handled.
- Maintain a log of calls for use in the reporting and tracking of calls handled.
- Liaison to other departments outside of the claims department.
- Provides back-up to the Claims Department staff, (claims examiners, data entry & clerical) Special projects and other duties as assigned by management.
- High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience.
Experience & Skills Required
- Minimum 2 years experience in medical claims environment.
- Minimum 2 years customer service experience.
- Strong interpersonal skills both oral and written.
- Demonstrated knowledge of computerized medical claims processing to include claims procedures and protocols.
- Demonstrated knowledge of workflow process.
- Demonstrated ability to provide excellent customer service.
- Bilingual Spanish a Plus.