Medical CS Rep I (***)
$38,251–$42,806 year
RemoteUnited States
Job Summary
Answer 50+ daily calls regarding claims, benefits, and eligibility from members, providers, and agents. Confirm coverage, verify premiums, collect payments, and resolve complaints or appeals while communicating professionally with frustrated callers. Apply mathematical skills to determine correct benefit information and premium amounts for individual plans. Review updated procedures, explain authorization requirements, update primary care selections, and gather banking details for monthly collections. Document all interactions accurately and meet service level time standards. Requires high-speed internet, 10-key proficiency, and ability to work evenings or weekends as needed.
Required Qualifications
- High school diploma or equivalent.
- High speed internet (cable or fiber)
- Must be proficient with Microsoft Office applications with the ability open and navigate multiple windows at the same time.
- Ability to achieve and maintain quality and quantity standards.
- Ability to work well under pressure in a complex and rapidly changing environment.
- Ability to be at work on time and daily.
- Maintain confidentiality and project a professional business presence.
- Ability to repeatedly analyze situations and communicate effectively in a fast-paced environment that includes dealing with angry people.
- Ability to organize and remain up to date on changing and new information.
- 10-key proficiency of 105 spm net on a computer numeric keypad.
- Type a minimum of 25 wpm net on a computer keyboard.
- Must be able to navigate multiple computer screens.
- Must be comfortable being on camera for virtual training and meetings.
- Work in excess of standard workweek, including evenings and occasional weekends, to meet business need.
Desired Qualifications
- Practical knowledge of medical terminology desired.
- Knowledge of diagnosis and procedure coding desired.
- Claim processing experience or prior customer service experience or other related experience such as medical/dental office experience.
Hiring someone like this?
Get your role in front of qualified candidates on Sorce.