Claims Customer Service Representative

| Remote
Sorry, this job was removed at 12:06 p.m. (CST) on Tuesday, August 4, 2020
Find out who’s hiring remotely
See all Remote jobs
Apply
By clicking Apply Now you agree to share your profile information with the hiring company.

At VillageMD, we are committed to help patients achieve greater health by delivering the most effective, accessible and efficient healthcare in the world through partnership with primary care physicians. We're in a unique position to impact everyone in primary care from independent, family-owned practices to world-class health systems.

 As a Claims Customer Service Representative on our team, your responsibilities will be to respond and resolve the most complex inquiries and questions for health care providers and members insurance claims. These will be related to medical care and benefits information, and direct members to the proper resources for further assistance with their issues. Researches and assists project team with resolution of provider claims inquires all lines of business.

 What are some examples of work you’ll be managing at VillageMD?

  • Furnish members and health care provider with details regarding benefits and claims processing
  • Advise members of outstanding co-payments and coinsurance
  • Log, track, resolve and respond to all assigned inquires and complaints while meeting all regulatory, CMS and corporate guidelines in which special care is required to protect and enhance VMD’s reputation
  • Research escalated issues and take appropriate action to resolve them within established service level agreements, VillageMD best practice, and quality standards
  • Apply a comprehensive knowledge of claims and provider contracts to completion of assignments
  • Strive to achieve first call resolution and maintain the quality of the call center
  • Investigate claims data to identify overpaid/incorrectly paid claims

 What will make you successful here?

  • A bias for action and pragmatic solutions
  • Ability to work quickly with great attention to detail
  • Technical claims handling experience
  • Knowledge of all products and all types of claims
  • Computer literate with an above-average typing speed
  • Demonstrate superb verbal and written communication skills
  • Ability to work in a fast-paced environment with changing priorities
  • Ability to work within tight timeframes and meet strict deadlines
  • Ability to exercise sound judgment
  • Prior experience as a Customer Service Specialist or equivalent, ideally within a similar setting
  • Ability to resolve conflict and diffuse tensions
  • A low ego and humility; an ability to gain trust through strong communication and doing what you say you will do

The following experience is relevant to us:

  • 5+ years of experience in a call center or customer service environment / researching and resolving operational issues
  • 3+ years of knowledge and experience in claims processing and Medicare rules of regulation

At VillageMD, we see diversity and inclusion as a source of strength in transforming healthcare. We believe building trust and innovation are best achieved through diverse perspectives. To us, acceptance and respect are rooted in an understanding that people do not experience things in the same way, including our healthcare system. Individuals seeking employment at VillageMD are considered without regard to race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

Read Full Job Description
Apply Now
By clicking Apply Now you agree to share your profile information with the hiring company.

Location

We are in the heart of downtown Chicago - accessible to all trains and plenty of food/drink options nearby!

Similar Jobs

Apply Now
By clicking Apply Now you agree to share your profile information with the hiring company.
Learn more about VillageMDFind similar jobs