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WebTPAPosted 1 month ago

Client Resolution Specialist

On-siteSan Antonio, Texas, United States

Full TimeEntry LevelHigh School Or EquivalentMediumHealthcare Tech

Job Summary

Handle inbound calls from providers and members to resolve complex client issues, partnering with Benefits departments to solve escalated claims. Track assigned client questions and needs proactively while researching claim appeals, benefit questions, and locating network providers. Provide direction and training to Customer Service Team staff when directed by the employer group or manager. Work directly with Benefit Consultants to address claim or customer service issues for employer groups. This role requires 1+ years of customer service experience and knowledge of healthcare coding and regulations. Based in San Antonio, TX, with flexible hours between 7:00am and 7:00pm CST.

Required Qualifications

  • 1+ years related work experience in customer service
  • High school diploma or GED
  • Knowledge in the healthcare industry including CPT and ICD-10 coding, COBRA, HIPAA, pre-existing conditions, and coordination of benefits
  • Concise written and oral communication skills
  • Ability to deal with conflict
  • Proficiency in maintaining good rapport with physicians, healthcare facilities, clients and providers
  • Knowledge of all MS Office products
  • Proven judgment, decision-making skills and the ability to analyze
  • Must be able to travel to multiple locations for work (i.e. travel to attend meetings, events, conferences). Occasionally
  • In office at 19100 Ridgewood Pkwy San Antonio, TX 78259
  • Ability to work between the hours of 7:00am - 7:00pm CST Monday to Friday

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