Claims Customer Service Representative
Portsmouth, NH 03801
Job Description
Responsibilities:
- Process Professional and Hospital claims accurately and timely within claiming system
- Process claims according to set guidelines for payment or denial
- Price claims according to Medicare, Medicaid and custom fee schedules
- Meet personal and team goals and metrics
- Manually enter data from CMS1500 and UB04 claims into claiming system as necessary
- Use available resources to manage workload
- Actively participate in staff meetings
- Communicate with supervisor on workload/issues/backlog
- Follow procedures, guidelines and policies
- Provide customer support for a 1-800 line inquiries as needed
- Assist with other duties as assigned
Qualifications:
- Proficient in Microsoft applications; particularly Word, Outlook and Excel
- Ability to understand and use all systems required to perform duties, using dual screens
- Ability to take initiative, prioritize tasks and manage workflow to meet deadlines
- Ability to interpret, comprehend and follow policies and plan provisions
- Excellent interpersonal skills
- Excellent oral and written communication skills
- Problem solving and analytical skills
- Demonstrated typing skills and accuracy rate
- Ability to work autonomously and within a team
Education:
- High School Diploma or Equivalent
Experience:
- Experience working in claims or healthcare environment as well as customer Service Call Center or Customer Facing positions
- Basic understanding of medical coding guidelines and medical terminology preferred
- Basic understanding of healthcare and claims concepts preferred
Meet Your Recruiter
Delsin Grubbs
Senior Recruiter
Delsin began working with The Panther Group in 2007. He left for a few years, then returned as a recruiter in 2013 after coaching high school football and winning a state championship with that team. He is father to a 14-year-old sophomore in high school.
Delsin loves all food, but eats sushi 2-3 times a week.
