Job Summary
A company is looking for a Healthcare Customer Service Rep II to provide member services related to policy management, benefits, and claims inquiries.
Key Responsibilities
- Process member payments, update member information, and handle policy terminations and reinstatements
- Provide accurate information on coverage plans and assist with prior authorizations and referrals
- Offer claims status updates and assist members with claims inquiries and reconsideration requests
Required Qualifications
- High School Diploma or GED required
- At least two years of experience in claims examination, health insurance, customer service, or a related healthcare field
- In-depth knowledge of healthcare terminology, eligibility, benefits, medical claims, and ICD-9/ICD-10 coding
- Must be able to pass a criminal background check
- Strong computer skills and ability to work independently or as part of a team
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