HMO CLAIMS CUSTOMER SERVICE REPRESENTATIVE - CLAIMS PROCESSING - Position #2022-475
- Date Posted:
- Full Time
- OPEN UNTIL FILLED Redlands Monday - Friday 6:00a.m. - 2:30p.m.
HMO Claims Customer Service Representative is responsible for successfully
managing large amounts of inbound calls. This will include following
communication scripts, handling different topics related to claims & health
care, and acting as a liaison between our company and its customers. In
addition, you will be responsible for evaluating documents to ensure that
appropriate information has been obtained for payment purposes.
School diploma or equivalent. Course work and knowledge of medical terminology
preferred. Inbound & Outbound calling experience in a call center, medical
office/clinic, hospital institution setting or one year of claims adjudication
experience in a Managed Care/IPA environment. Two years of claims adjudication
experience in a Managed Care/IPA Claims environment with Customer service call
center knowledge preferred. Must have
excellent verbal, written and interpersonal communication skills. Must be proficiently skilled in the
application and use of Windows, Excel, Outlook and the Internet. Knowledge of
some medical terminology, ICD9 and CPT/HCPCS codes required; clerical ability
necessary, including ten-key calculator, computer, and light (35 wpm with
accuracy) typing skills.
Beaver Medical Group
requires all new hires and employees to report their COVID-19 vaccination
Applications must be complete and demonstrate that the
minimum qualifications are met. Resumes may be attached to completed
application form as supplemental information, but will not be accepted in lieu
of an official application form. Applications will be screened and the most
qualified candidates who best match the needs of the position will be invited
to compete further in the recruitment process. Due to the large
volume of applications received, we are unable to track for individual
applications or discuss the application process.