Description
What You’ll Do :
- Distributes daily work to employees, tracks workload and employee performance, and makes appropriate decisions necessary to ensure all processing expectations and team goals are met.
- Responds accurately and timely to inquiries from team members, including management, concerning customer inquiries, claims adjudication, appeals and other technical issues.
- Investigates and initiates resolutions to complex problems.
- Authorizes payment recovery, claim payments, or makes claim rejections based on documented information and provisions of state or federal law.
- Identifies issues with procedures and processes and provides feedback to management on changes and development.
- Trains new employees and introduces new material to all employees.
- Develops, updates, and maintains procedural manuals.
- Serves as liaison with other departments to address claim, system and quality issues.
- May perform some testing functions and attend / participate in meetings as needed.
To Qualify for This Position, You’ll Need :
- High School Diploma or equivalent
- 3 years of customer service experience and 1 year of claims or appeals processing experience OR Bachelor’s Degree in lieu of work experience.
- Excellent verbal and written communication skills.
- Strong customer service skills.
- Proficient spelling, punctuation, grammar, and basic business math.
- Ability to handle confidential or sensitive information with discretion.
- Knowledge of claims processing procedures.
- Experience with Microsoft Office.
What Blue Can Do For You :
- 401(k) retirement savings plan with company match
- Subsidized health plans and free vision coverage
- Life insurance
- Paid annual leave the longer you work here, the more you earn
- Nine paid holidays
- On-site cafeterias and fitness centers in major locations
- Wellness programs and a healthy lifestyle premium discount
- Tuition assistance
- Service recognition
Facility Customer Service Coordinator
The Facility Coordinator works closely with customers to determine their needs, answer their questions about Sherwin-Williams products, and recommend the right solutions. Ensure high levels of customers satisfaction through excellent service. Must have at least one (1) year of work experience in cus...
Facility Customer Service Coordinator
The Facility Coordinator works closely with customers to determine their needs, answer their questions about Sherwin-Williams products, and recommend the right solutions. This position contributes to the growth of our business through supporting current and potential customers, handling inquiries an...
Facility Customer Service Coordinator
The Facility Coordinator works closely with customers to determine their needs, answer their questions about Sherwin-Williams products, and recommend the right solutions. Ensure high levels of customers satisfaction through excellent service. Must have at least one (1) year of work experience in cus...
Claims Customer Service
Job Title: Claims Customer Service. Strong customer service skills. Provides prompt, accurate, thorough and courteous responses to all customer inquiries. Ensures effective customer relations by responding accurately, timely, and courteously to telephone, written, web, or walk-in inquiries. ...
Claims Customer Service Advocate III
Reviews claims or appeals issues, complaints, and inquiries referred by claims customer service representatives to determine if desk procedures and guidelines were followed. Assists in training claims customer service representatives. Strong customer service skills. Researches and responds to comple...
Claims Customer Service Advocate I
Strong customer service skills. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to return, deny or pay claims following organizational policies and procedures. ...
Claims Customer Service Advocate II
Please list out the top - PREFERRED/NICE TO HAVE skill sets/qualities: Medical background, office experience, customer service, previous call center experience. Strong customer service skills. Please provide a few sentences describing what a typical day would like in this role: Candidate would handl...
Claims Customer Service Advocate
Job Title: Claims Customer Service Advocate. Required Work Experience: 2 years of customer service experience including 1 year claims or appeals processing OR Bachelor's Degree in lieu of work experience. Strong customer service skills. Responsible for responding to customer inquiries. ...
Claims Customer Service Advocate II
Strong customer service skills. Two years customer service experience in an office environment. Ensures effective customer relations by responding accurately, timely, and courteously to telephone, written, web, or walk-in inquiries. Identifies incorrectly processed claims and processes adjustments a...
Facility Customer Service Coordinator
The Facility Coordinator works closely with customers to determine their needs, answer their questions about Sherwin-Williams products, and recommend the right solutions. Ensure high levels of customers satisfaction through excellent service. Must have at least one (1) year of work experience in cus...