North Carolina Healthcare Customer Service Rep

Job Summary

A company is looking for a Healthcare Customer Service Rep II.

Key Responsibilities

• Process member payments, address billing inquiries, and resolve billing discrepancies
• Provide accurate information about coverage plans and assist with prior authorizations and referrals
• Handle claims inquiries and status updates, including assisting with reconsideration requests for denied claims

Required Qualifications

• High School Diploma or GED required
• At least two years of experience in claims examination, health insurance, customer service, or a healthcare-related field
• Solid understanding of healthcare medical claims, benefits, and policy processes
• In-depth knowledge of healthcare terminologies, including ICD-9 and ICD-10 coding
• Must be able to clear a criminal background check