Senior Customer Service Specialist

Job Summary

A company is looking for a Sr. Customer Service Specialist responsible for managing complex claims inquiries and mentoring team members.

Key Responsibilities

• Investigate and resolve complex claims inquiries from various stakeholders, including handling legal inquiries
• Document investigative notes and ensure compliance with department standards for production and accuracy
• Coach and mentor less experienced team members on claims handling and assist in training new staff

Required Qualifications

• Minimum completion of high school (diploma or GED)
• At least 3 years of experience in the healthcare industry or customer service, preferably with out-of-network claims
• Required licensures, professional certifications, and/or Board certifications as applicable
• Bilingual English/Spanish may be required for some positions
• Knowledge of healthcare claims and appeal procedures, as well as insurance vocabulary