Pennsylvania Licensed Healthcare Customer Service Rep

Job Summary

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

Key Responsibilities

• Process member payments, address billing inquiries, and manage policy terminations and reinstatements
• Provide accurate information on coverage plans and assist with prior authorization and referral processes
• Handle claims status updates and inquiries, and assist members 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 roles
• Proven experience in customer service related to claims processing or billing
• Comprehensive knowledge of medical terminology and ICD-9/ICD-10 coding
• Must pass a criminal background check