Top 4223 Claim Resolution Representative Jobs

Call Center Member Service Representative
United Faith Ministries Inc —Orange, CA
- $25 an hour
- Overtime
- Microsoft Outlook
- Computer literacy
- Research
- 403(b) matching
- Dental insurance
Quick Apply
Allowables Representative
TeamHealth —Remote
- Full-time
- Remote
- Word processing
- Computer literacy
- Mid-level
- Paid holidays
- Health insurance
11d
Remote Healthcare Customer Service Representative
Conduent Commercial Solutions, LLC —Remote
- $16 an hour
- Email
- Remote
- Background check
- Microsoft Outlook
- Computer literacy
- Paid training
- Paid holidays
Medicare Account Resolution Specialist - Digitech - Remote
Sarnova —Remote
- Full-time
- Remote
- Microsoft Outlook
- Word processing
- Computer literacy
- 401(k)
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Patient Account Representative - Remote
Med-Metrix —Remote
- Full-time
- Remote
- Customer service
- Basic math
- HIPAA
Contact Center - CSR-1 - Customer Service Representative 1
Wellcove —Remote
- Full-time
- Remote
- Background check
- High school diploma or GED
- Typing
Quick Apply
11d
Customer Service Representative - Part Time (Remote)
GETIX HEALTH —Houston, TX
- $17 an hour
- Part-time
- Remote
- Spanish
- HIPAA
- English
Quick Apply
Customer Service - Work at Home
ibex Limited —Hampton, VA
- Remote
- Entry level
- Paid training
- Health insurance
Customer Service Representative
ibex Limited —Washington, DC
- Weekends as needed
- 18 years or older
- HIPAA
- High school diploma or GED
- Paid training
- Opportunities for advancement
Account Resolution Representative
Children's Wisconsin —West Allis, WI
- Full-time
- Remote
- Anatomy knowledge
- HIPAA
- Research
- Flexible schedule
Healthcare Customer Service Representative
University of Colorado Medicine —Remote
- $22 - $25 an hour
- Full-time
- Remote
- Research
- Mid-level
- High school diploma or GED
- Health insurance
- Opportunities for advancement
12d
Account Resolution Specialist - Insurance HMOs - Digitech - Remote
Sarnova —Remote
- Full-time
- Remote
- Microsoft Outlook
- Word processing
- Research
- 401(k)
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Claims Customer Service Representative I
Partnership HealthPlan of California —Fairfield, CA
- $29.95 - $35.19 an hour
- Full-time
- Computer literacy
- Research
- High school diploma or GED
Senior Enrollment Representative
Optum —Eden Prairie, MN
- $20.38 - $36.44 an hour
- Full-time
- Remote
- Microsoft Word
- Pass drug screening
- Research
- Flextime
Call Center Representative-Remote TX Resident
OrthoLoneStar —Houston, TX
- Full-time
- Microsoft Excel
- Microsoft Outlook
- HIPAA
Claim Representative III - Property
Capital Insurance Group —San Jose, CA
- $77,406 - $129,010 a year
- Full-time
- Mid-level
- 3 years
- US work authorization
- Profit sharing
- Commuter assistance
Telephone Representative II (Provider Relations)
1199SEIU Family of Funds —New York, NY
- $49,495.68 - $62,570.04 a year
- Full-time
- Research
- Mid-level
- High school diploma or GED
- Vision insurance
Patient Services Representative I - Remote - Nationwide
Vituity —Sacramento, CA
- $17.12 - $19.04 an hour
- Overtime
- Remote
- Spanish
- Basic math
- Windows
- Profit sharing
- Wellness program
Revenue Cycle Representative
UNC Health —Raleigh, NC
- $18.12 - $25.51 an hour
- Full-time
- Remote
- Research
- Mid-level
- High school diploma or GED
4d
Claims EDI Helpdesk Support
RADcube —Remote
- Full-time
- Remote
- Background check
- High school diploma or GED
- 1 year

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Call Center Member Service Representative

United Faith Ministries Inc -
Orange, CA

Quick Apply

Job Details

Full-time
$25 an hour

Benefits

403(b) matching
Dental insurance
Paid time off
Vision insurance
403(b)

Qualifications

Customer communication
High school diploma or GED

Full Job Description

Call Center Member Service Representative

Healthcare is increasingly unaffordable for many Americans. For those who can afford it, they are in a health insurance system that has become more confusing, restrictive, and lower value with each passing year. Here at WeShare our mission is to bring better healthcare to America at a better price. We offer consumers a member-to-member health sharing program that is much more cost effective than standard health insurance while providing access to over 1.2 million physicians across the country. Come join us on this important journey to create the next generation of healthcare!

WeShare is a rapidly growing faith-based nonprofit that strives to do good while delivering great and affordable healthcare. The company is led by senior executives with an extensive background in both for-profit and not-for-profit enterprises. If you have a bias for action, enjoy challenges, and love creating impact in a massive industry, WeShare might be the place for you!

About this role

Our Customer/Member Services Representatives are one of the most important pillars to our success. As you’re directly interfacing with our valuable members. We’re looking for top-tier talent who takes ownership in creating a successful journey for our clients. This is a challenging role that requires an emphasis on customer centricity, high energy, and work with the highest purpose of customer satisfaction and retention.

Key Responsibilities

Answering phones from members professionally and responding to member inquiries and complaints
Handle escalated calls, resolving more complex member issues in (First Call Resolution - FCR)
Demonstrate outstanding service to identify the source of the issue and work to resolve member inquiries and issues in a timely and professional manner, related to benefits, eligibility and claims, financial spending accounts and correspondence
Research complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues
Responsible for knowing all aspects of health program benefits including medical and pharmacy
Required to be at workstation to answer calls in an ACD environment, subject to the monitoring of incoming and outgoing ACD calls for quality assurance during those time periods that the CSA is not scheduled for a break or lunch breaks
Identifying, escalating priority issues, and reporting to high-level management
Responsible for taking issues on a weekly basis to the dept. manager
Obtaining and evaluating all relevant data to handle complaints and inquiries
Handling outbound and inbound calls from external and internal customers
Completing call reports, logs, and researching billing issues
Recognizing, documenting, and informing the supervisor regarding the trends in internal and external customer calls

Required Qualifications

High School Diploma/GED (or higher)
6+ months of Call/Contact Center experience
6+ months of Customer Service experience analyzing and solving customer problems

Preferred Qualifications

Healthcare or Insurance Call/Contact Center experience
Ability to create, modify and send documents, spreadsheets, and emails in Microsoft Excel, Word, and Outlook
Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations (responding in respectful, timely manners, consistently meeting commitments)
Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests, and identify the current and future needs of the member
A proficient problem-solving approach to quickly assess the current state and formulate recommendations
Proficient in translating healthcare-related jargon and complex processes into simple, step-by-step instructions customers can understand and act upon
Flexibility to customize the approach to meet all types of member communication styles and personalities
Proficient conflict management skills include the ability to resolve issues in a stressful situation and demonstrating personal resilience
Ability to work regularly scheduled shifts within our hours of operation including the training period where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and workover-time and/or weekends, as needed
All new hires will be required to successfully complete the Customer Service training classes and demonstrate proficiency of the material
Ability to work within a team and collaborative environment
Ability to multi-task including the ability to understand multiple products and multiple levels of benefits within each product
Demonstrated ability in customer service problem resolution and relationship building
Being able to address high-level concerns and satisfy them using scripting
Familiarity with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications
Able to work overtime evenings, weekends and holidays as needed based on the needs of the business

What we offer

Competitive Hourly+ PTO
Health, Dental, Vision, and 403(b) with company match
Ability to make important enhancements to the Healthcare industry
Great culture where you work with the founders and key stakeholders in a relaxed, but innovative atmosphere

UHSM is an Equal Opportunity Employer. Our business is fast-paced and will continue to evolve. As such, the duties and responsibilities of this role may be changed as directed by the Company at any time to promote and support our business needs. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, gender expression, national origin, protected veteran status, or any other basis protected by applicable law and will not be discriminated against on the basis of disability.

Quick Apply

Refine Your Search

Claim Resolution Representative jobs

Call Center Member Service Representative

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Remote Healthcare Customer Service Representative

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Patient Account Representative - Remote

Contact Center - CSR-1 - Customer Service Representative 1

Customer Service Representative - Part Time (Remote)

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Call Center Representative-Remote TX Resident

Claim Representative III - Property

Telephone Representative II (Provider Relations)

Patient Services Representative I - Remote - Nationwide

Revenue Cycle Representative

Claims EDI Helpdesk Support

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