Medical Customer Service Representative

Job Summary

Providing phone customer service to members of multiple benefit plans, the full-time Medical Customer Service Representative will analyze caller needs and deliver timely responses regarding benefits, claims processing, and health plan details while working from home.

Key responsibilities

• Answer over 50 calls daily related to claims and benefit inquiries, providing accurate solutions and confirming eligibility
• Document all call interactions clearly and concisely while maintaining confidentiality and professionalism
• Review and explain authorization requirements and assist members in finding suitable healthcare providers

Required qualifications

• High school diploma or equivalent
• Practical knowledge of medical terminology and diagnosis/procedure coding is desired
• Experience in claim processing or customer service, preferably in a medical/dental office setting
• Proficiency in Microsoft Office applications and ability to navigate multiple computer screens
• Ability to type a minimum of 25 wpm and achieve 105 spm net on a computer numeric keypad