Claims Research & Resolution Representative

Employer Industry

Healthcare Insurance

• Salary up to $52,300 per year
• Competitive benefits including medical, dental, and vision coverage, 401(k) retirement savings plan, and paid time off
• Opportunity for career advancement within a Fortune 100 company
• Work remotely with the flexibility to manage home-office requirements
• Supportive company culture that values associate engagement and well-being

• Manage inbound calls to address customer inquiries, including complex financial recovery and issue resolution
• Record details of interactions and take appropriate action based on inquiries or complaints
• Escalate unresolved customer inquiries as necessary
• Interpret policies and procedures to complete assignments with some latitude for discretion
• Maintain confidentiality and adhere to quality standards while working remotely

• 1 or more years of call center or telephonic customer service experience within the past 5 years
• Previous healthcare-related experience or education
• Basic proficiency in Microsoft Office (Word, Excel, Outlook, and Teams)
• Strong technical skills to navigate multiple software systems
• Demonstrated time management and prioritization skills

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