Experienced Customer Service Representative - Medical Claims Processing for Remote Health Benefits Company

Join Our Team: Revolutionizing Health Benefits Administration

At Workwarp, a leading innovator in the health benefits industry, we're committed to delivering exceptional customer experiences and streamlining claims processing for our clients. As a Customer Service Representative - Medical Claims, you'll be at the forefront of our mission, providing top-notch support to healthcare providers and members alike. If you're passionate about delivering outstanding customer service and have a knack for navigating complex claims processes, we invite you to explore this exciting opportunity.

About Us: Workwarp and Nesco Resource Partnership

Workwarp has partnered with Nesco Resource, a renowned staffing and workforce solutions provider, to identify top talent for this critical role. Nesco Resource is dedicated to fostering a culture of inclusivity, diversity, and equal employment opportunities. Together, we're committed to creating a work environment that is engaging, supportive, and conducive to growth.

Job Summary: Customer Service Representative - Medical Claims

As a Customer Service Representative - Medical Claims, you'll serve as the primary liaison between our clients, healthcare providers, and members, ensuring seamless claims processing and resolving issues efficiently. This role requires a unique blend of technical expertise, exceptional communication skills, and a customer-centric approach.

Key Responsibilities:

• Manage daily claims management tasks, providing detailed claim notes and resolving issues in a timely manner.
• Communicate effectively with healthcare providers and members via multiple channels (phone, email, etc.) to educate them on claims processes, required documentation, and benefit plans.
• Accurately enter verbal and written application information into our claims management system, meeting both internal and external customer requirements.
• Assign new claims to the appropriate claims handler and direct customer calls to the relevant contact or escalation path as needed.
• Maintain a high level of attendance and adhere to scheduled work hours, ensuring consistent support for our clients.
• Perform other duties as assigned, supporting the organization's quality program(s) and contributing to the team's overall success.

Essential Qualifications:

To excel in this role, you'll need:

• Prior experience in claims processing and customer service, preferably in the healthcare or health benefits industry.
• Strong technical skills, including proficiency in claims management systems and Microsoft Office applications.
• Excellent communication and interpersonal skills, with the ability to effectively interact with diverse stakeholders.
• US Citizenship is required for this role.
• The ability to work a set shift, with available schedules including 8:00am - 4:30pm, 8:30am - 5:00pm, or 11:30am - 8:00pm.

Preferred Qualifications:

While not mandatory, the following qualifications can enhance your candidacy:

• Previous experience working in a remote or call center environment.
• Familiarity with health benefits administration, including knowledge of medical claims processing and benefit plans.
• Strong analytical and problem-solving skills, with the ability to navigate complex claims issues.

Skills and Competencies:

To succeed in this role, you'll need to possess:

• Exceptional customer service skills, with a focus on empathy, active listening, and issue resolution.
• Strong communication and interpersonal skills, with the ability to effectively interact with diverse stakeholders.
• Technical skills, including proficiency in claims management systems and Microsoft Office applications.
• Analytical and problem-solving skills, with the ability to navigate complex claims issues.
• Attention to detail and organizational skills, with the ability to manage multiple tasks and priorities.

Career Growth Opportunities and Learning Benefits:

At Nesco Resource and Workwarp, we're committed to supporting your long-term career goals. As a Customer Service Representative - Medical Claims, you'll have opportunities to:

• Develop your technical expertise in claims processing and health benefits administration.
• Enhance your customer service and communication skills, with a focus on issue resolution and stakeholder management.
• Explore career advancement opportunities within the organization, including leadership roles or specialized positions.

Work Environment and Company Culture:

As a remote employee, you'll enjoy the flexibility and autonomy of working from home, while remaining connected to our team through regular virtual interactions. Our company culture is built on a foundation of:

• Inclusivity and diversity, with a commitment to equal employment opportunities.
• Employee support and engagement, with access to comprehensive benefits and resources.
• Continuous learning and development, with opportunities for growth and career advancement.

Compensation, Perks, and Benefits:

Nesco Resource offers a comprehensive benefits package, including:

• A competitive salary, with opportunities for growth and development.
• A MEC (Minimum Essential Coverage) plan that encompasses Medical, Vision, Dental, 401K, and EAP (Employee Assistance Program) services.
• Opportunities for career advancement and professional growth.
• A dynamic and supportive work environment, with a focus on employee well-being and engagement.

Ready to Join Our Team?

If you're a motivated and customer-focused professional looking to make a meaningful impact in the health benefits industry, we encourage you to apply for this exciting opportunity. As a Customer Service Representative - Medical Claims, you'll be at the forefront of our mission, delivering exceptional support to healthcare providers and members alike. Don't miss this chance to join our team and shape the future of health benefits administration.

To get started, simply click the "Apply Now" link below. Our team will review your application and be in touch soon to discuss this opportunity further.