Claims Examiner/Member Services Representative
$52,000–$54,080 year
HybridPortland, Oregon, United States
Job Summary
Process medical, dental, and vision claims with speed and accuracy while professionally responding to member and provider requests via telephone, email, and in-person. Assess and resolve problems within your scope of authority, escalating complex issues to senior staff as needed. Clearly document all customer contacts and support other claims examiners and the administrative team. Maintain excellent interpersonal skills and employ clarity, efficiency, and compassion in all communications. This full-time, in-office role converts to hybrid work after the initial training period.
Required Qualifications
- HS Diploma
- college degree
- Two years claims experience in a healthcare environment
- Excellent written and verbal communication skills
- Knowledge of medical terminology, billing, and IDC-10 and CPT codes
- Keen attention to detail
- analytically and mathematically inclined
- Proficiency in Microsoft Office suite
- Excellent time-management, problem-solving, and organizational skills
- Must be mature
- reliable
- stellar work ethic
- enthusiasm
- initiative
- curiosity
- Patience
- sense of humor
Desired Qualifications
- college degree
- Customer service experience
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