Claims Customer Service Representative
Secura - Appleton, WI

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Set up claim files and verify coverage
  • Assign new losses to Claims Representatives
  • Process claim checks
  • Answer general claims questions or forward calls to the appropriate contact
  • Process incoming and outgoing mail
  • Maintain the paperless filing system
  • Resolve medical-only claims
  • Provide superior customer service for all internal and external customers
  • Review and analyze payment of medical charges
  • Handle escheats and bulk billing payments
  • Prepare Excel spreadsheets and data analysis
  • Process and ensure compliance with Medicare SCHIP reporting
  • Provide backup assistance for Senior CSRs and Technical Specialists

  • Qualifications:

    Required:
    • High school diploma or GED
    • Fluency in Spanish
    • Great keyboard/PC skills
    • Superior verbal communication skills
    • Excellent problem-solving skills
    • Great organization and prioritization skills
    • Highly proficient in Excel (including complex formulas, data analysis,
      etc.)
    • Must have an A+ team attitude

    Desired:
    • Medical claims experience and/or medical records terminology knowledge
    • Associate‚Äôs or college degree
    • Introductory insurance coursework
    • Previous customer service experience
    • Basic understanding of property and casualty insurance

    Secura - 20 months ago - save job