Essential Functions of Job:|
- Handling customer service calls from members, providers and client representatives
- Analyzing problems brought forth during phone inquiry and applying appropriate resolutions
- Work with Analysts and other departments to research problems
- Establishing and maintaining professional rapport with clients and providers (physicians and hospitals)
- Maintaining and assuring accuracy of documentation
- Continuous knowledge of numerous benefit interpretations
- Assist in on the job training of new members
- Ability to learn claim processing as well as adjustments
- Ability to report to the office
The Company considers applicants without regard to race, color, national origin, sex, religion, mental or physical disability, marital status, age 40 years and over, sexual preference, veteran's status, or other characteristic protected by applicable law.
- 2-3 years Medical field, Customer Service and or Claims Processing background preferred
- Working knowledge of CPT-4 coding, ICD9 and overall medical terminology usage
- Excellent communication and telephone skills
- Excellent organizational and prioritization skills
- Demonstrated ability to work in a multi-task deadline driven environment
- Demonstrated ability to function as a positive team member
- Must be efficient in Microsoft Office with excellent keyboard skills
- High school diploma or equivalent
- Ability to understand and speak Spanish a plus
Applications for this vacancy will be received for 3 working days after the Posted date from Employees of HealthSCOPE Benefits with more than one year of service.
Applications for this vacancy will be received for 10 working days after the Posted date from External Applicants.