Claims Processor/Customer ServiceJuly 14, 2023 2023-07-14 14:19
Claims Processor Customer Service:
- Serves customers by determining insurance coverage;
- examining and resolving claims issues;
- documenting actions;
- maintaining quality customer services;
- ensuring legal compliance.
- Determines covered benefits by studying provisions of policy or certificate.
- Establishes proof by studying documentation;
- assembling additional information as required from outside sources, including claimant, physician, employer, and other insurance companies
- Process claims by approving or denying documentation;
- calculating benefit due; initiating payment or composing denial letter.
- Ensures compliance by following company policies, procedures, guidelines, as well as state and federal insurance regulations.
- Maintains quality customer services by following customer service practices; responding to customer inquiries.
- Protects operations by keeping claims information confidential.
- Prepares reports by collecting, analyzing, and summarizing information.
- Updates job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations.
- Accomplishes organization goals by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments.
- Claims Experience
- Documentation Skills
- Data Entry Skills
- Analyzing Information
- Problem Solving
- Verbal Communication
- Customer Focus
- General Math Skills
- Proficient with Microsoft Office applications (Word Excel, Outlook, PowerPoint )
Contact Rob with resume. firstname.lastname@example.org
To apply for this job email your details to email@example.com