Pennsylvania Licensed Healthcare Customer Service Rep

Job Summary

A company is looking for a Healthcare Customer Service Rep II.

Key Responsibilities

• Process member payments, update member information, and handle policy terminations and reinstatements
• Provide accurate information regarding coverage, assist with prior authorizations, and conduct research for healthcare provider contacts
• Answer claims inquiries, provide status updates, and assist with reconsideration requests for denied claims

Required Qualifications

• High School Diploma or GED required
• Minimum of 2 years of experience in claims examination, health insurance, customer service, or medical office settings
• Proven experience in customer service related to claims processing or billing
• Comprehensive knowledge of medical terminology, eligibility verification, and medical claims processing
• Must successfully pass a criminal background check