Claims Processor Customer Service Focus

Position: Claims Processor 3 with Customer Service Focus
Join a dynamic team as a Claims Processor 3, specializing in health claims processing and customer interactions. This role requires independent claim handling and a proactive customer service approach.

In this position, you will manage the full spectrum of health claims for assigned Plans and provide crucial support to both providers and members. Your in-depth knowledge of claims processing and related terminology will be vital for effective claim payments, and your involvement in team efforts will help minimize processing backlogs.

Key Responsibilities:

• Independently process health claims in line with assigned Plans

• Handle customer service inquiries for both providers and members

• Create correspondence and transaction letters as needed

• Stay updated on assigned Plans to inform claim payments

• Support colleagues with claims processing as assigned

Requirements:

• High school diploma or GED; minimum 2 years of claims experience

• Solid understanding of benefits claims processing principles

• Typing proficiency of at least 45 WPM

• Effective communication skills in group and individual settings

• Proven ability to solve practical challenges and meet goals

Utilize your expertise in claims processing to drive efficiency and member satisfaction.
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