West Virginia Healthcare Customer Service Rep

Job Summary

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

Key Responsibilities

• Process member payments, update member information, and handle policy terminations and reinstatements
• Provide accurate coverage information and assist with prior authorization and referral processes
• Answer claims inquiries, provide status updates, and assist with claims reconsideration requests

Required Qualifications

• High School Diploma or GED required
• Minimum of 2 years experience in claims examination, health insurance, customer service, or medical office
• Proven experience in customer service related to claims processing or billing
• Comprehensive knowledge of medical terminology, ICD-9, and ICD-10 coding
• Must successfully pass a criminal background check