Senior Customer Service Specialist

Job Summary

A company is looking for a Sr. Customer Service Specialist responsible for handling complex claims inquiries and mentoring team members.

Key Responsibilities

• Investigate and resolve complex claims inquiries from various stakeholders, including patients and providers
• Provide business correspondence and ensure compliance with turnaround requirements and documentation standards
• Coach and mentor less experienced team members while assisting in training and various research projects

Required Qualifications

• Minimum completion of high school (diploma or GED)
• At least 3 years of experience in the healthcare industry or customer service, preferably with out-of-network claims
• Required licensures or professional certifications as applicable
• Bilingual English/Spanish may be required for some positions
• Knowledge of healthcare claims and appeal procedures