Claims Customer Service Representative. Brookhaven Move Collective

We are seeking a Claims Customer Service Representative for one of our clients in Brookhaven, GA. The Claims Customer Service Representative is responsible for handling high-volume inbound calls from policyholders and healthcare providers. This role focuses on resolving claim-related inquiries, providing accurate insurance information, and delivering excellent customer service with an emphasis on first-call resolution.

• Handle a high volume of inbound customer service calls in a professional and efficient manner
• Respond to inquiries related to insurance policies, benefits, coverage, and claims
• Aim for first-call resolution while maintaining a positive customer experience
• Assist healthcare providers with claim processing and submission guidance
• Explain claim adjudication outcomes, reimbursement procedures, and policy details
• Ensure compliance with Medicare, CMS, and industry regulations
• Accurately document all customer interactions and claim-related activity
• Escalate complex or unresolved issues to the appropriate department
• Collaborate with internal teams to support efficient claims and service operations

• Strong knowledge of Medicare Supplement and other applicable insurance products
• Understanding of healthcare claim adjudication processes
• Experience in a high-volume inbound call environment
• Excellent verbal and written communication skills
• Strong problem-solving skills and attention to detail
• Ability to work independently and collaboratively within a team
• Proficiency with customer service systems, databases, and related tools
• Education
  - High school diploma or equivalent

• Bilingual proficiency in English and Spanish, with the ability to clearly communicate insurance and claims information to diverse audiences.

• Customer service excellence
• Empathy and patience with customers and providers
• Clear and effective communication
• Time management and multitasking in a fast-paced environment
• Attention to accuracy and documentation
• Adaptability to changing policies, guidelines, and procedures

Location: Brookhaven, GA

Job Type: Onsite | Direct Hire | Full-Time

Pay Details: $50,000.00 to $53,000.00 per year

Search managed by: Coleman Harris

Equal Opportunity Employer/Veterans/Disabled

Military connected talent encouraged to apply

The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:

• The California Fair Chance Act
• Los Angeles City Fair Chance Ordinance
• Los Angeles County Fair Chance Ordinance for Employers
• San Francisco Fair Chance Ordinance

Massachusetts Candidates Only:
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.