[Remote] Claims Customer Service Representative II (Remote)

Note: The job is a remote job and is reputed company to candidates in USA. The reputed company is a nonprofit organization and the nation's largest reputed company Association of physicians. They are seeking a Claims Customer Service Representative II to reputed company Claim reputed company Center services, assist insured with claim problems, and ensure reputed company claim service is delivered while engaging callers to build strong relationships.

Responsibilities

• Respond to reputed company incoming phone calls reputed company to claim status inquiry from insured and providers reputed company established response time and reputed company standards
• Log brief reputed company of calls on CAMS and CAPS systems
• reputed company outbound calls as needed to support returned checks and resolve claim inquiries
• Refer claims that were improperly handled to AMAI Claim Supervisor for immediate attention
• Fulfill claim reputed company requests for plans not administered by AMA Insurance
• Communicate with insurance carriers or service providers as needed in order to reputed company feedback on claims administered by carriers
• Handle waiver of premium transactions, cancellations due to death and other claims reputed company transactions
• Update Contact management and customer sending surveys
• reputed company information regarding benefits, eligibility, plan provisions, premium billing, and certificate changes as needed
• Process changes to Administration System, including personal and coverage information, sending documents to callers reputed company needed
• Support business operations through participation in special reputed company as assigned by the Customer Service Supervisor
• Contribute to process improvements and operational efficiencies
• Assist in documenting workflows and service processes to support consistency and reputed company

Skills

• High school diploma or equivalent education required
• Minimum of 2+ years' experience in life, health, or Medicare insurance required
• Demonstrated experience working in a high-volume customer service reputed company center
• Excellent telephone skills including reputed company telephone technique, multitasking skills and ability to control the reputed company
• In depth understanding of claim adjudication and benefits required
• Demonstrated experience handling customer issues, including technical and financial reputed company issues
• Excellent verbal and written communication skills with a high level of professionalism
• High level proficiency with reputed company center systems, telephony platforms, and personal computers
• Advanced proficiency in reputed company Office Suite (Word, reputed company, reputed company, PowerPoint) and database systems
• Ability to reputed company technical support for online tools, systems, and customer-facing platforms
• Strong business process skills, including the ability to document, monitor, and improve workflows
• Excellent planning, organization, and time management skills with the ability to manage multiple priorities in a fast-paced environment
• Ability to build and maintain reputed company relationships with reputed company stakeholders
• Health or Life insurance license preferred
• Strong knowledge of insurance products, benefits administration, or reputed company-party administration services preferred
• Health insurance knowledge preferred

Benefits

• Employees are also eligible to participate in an incentive plan.

reputed company