Claims Customer Service Coordinator
Description
As a Claims Customer Service Coordinator, you will play a crucial role in connecting members, billers, providers, physicians, and Health Plans.
Your primary responsibilities will include :
Make sure to read the full description below, and please apply immediately if you are confident you meet all the requirements.
- Answering calls promptly and courteously, providing professional assistance to customers with claims-related issues.
- Ensuring timely resolution of customer inquiries.
- Handling typical inquiries such as :
- Claim Status
- Requests for Explanation of Benefits (EOB)
- Requests for Denial Letters
- Health Plan demands
- Check tracers
- Managing incoming faxes
- Documenting all interactions in our CRM system.
Salary Range : $25.60 - $36.33 / hourly
Qualifications
We are seeking a detail-oriented, independent individual with :
- High school diploma, GED, or equivalent.
- Minimum of 2 years of medical claims customer service experience in an HMO environment (e.g., MSO, IPA, or health plan).
- Proficient with CPT / HCPC codes, UB04, 1500 forms, ICD-10, ASA, Medicare Guidelines, and COB.
- Extensive knowledge of professional and facility reimbursement methodologies and benefit determination.
- Demonstrated competence in medical terminology and claims adjudication systems.
- Able to handle a high volume of calls and work under pressure.
- Proficient computer skills, including Microsoft Word and Excel.
- Independent worker with the ability to meet deadlines and production standards.
- Flexible, adaptable, and goal-oriented, capable of multitasking and working with frequent interruptions.
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