Claims Research & Resolution Representative

Employer Industry: Healthcare Insurance

• Salary up to $52,300 per year
• Opportunity for career advancement and growth within the organization
• Work remotely with flexible hours
• Comprehensive benefits package including medical, dental, vision, and retirement plans
• Supportive and collaborative work environment
• Commitment to associate engagement and well‑being

• Manage inbound calls to address customer needs, including complex financial recovery and issue resolution
• Record detailed notes of inquiries, comments, or complaints, and take appropriate action
• Escalate unresolved and pending customer inquiries as necessary
• Interpret area or department policy to make decisions related to assignments
• Work independently within defined parameters to meet quality standards

• 1 or more years of call center or telephonic customer service experience within the past 5 years
• Previous healthcare‑related experience or education
• Basic Microsoft Office skills (Word, Excel, Outlook, and Teams)
• Strong technical skills to navigate multiple software systems
• Ability to manage multiple priorities and maintain confidentiality while working remotely

• Bachelor's degree
• Prior claims processing experience
• Experience in financial recovery and over payment resolution
• Familiarity with Mentor software or similar systems
• Experience with CRM systems

We prioritize candidate privacy and champion equal‑opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately. We are not the EOR (Employer of Record) for this position.

Our role in this specific opportunity is to connect outstanding candidates with a top‑tier employer.