Company in Phoenix looking for 3 Claims Customer Service Representatives ASAP! Temp -- $15/hour Overview: Support the Claims Department by answering incoming phone calls from providers primarily regarding claim status. Additionally, the Customer Service Specialist will update logs, coordinate pend release and follow up with claims resolution. Primary duties include the following: o Responds to telephone customer inquiries within the standards set. Consistently keeps commitments to providers by returning telephone calls and initiating follow-up as promised. o Providing claim status to providers by either phone or in the form of research projects o Identifies and brings to the attention of the Supervisor, those claims considered to be unusual in terms of dollar amount, provider/service type, dates and/or location of service, member eligibility, or that do not meet or are appropriately addressed by Phoenix Health Plan policies and procedures. o Follows up with claims resolution from status calls o Accurately and efficiently pends claims for later resolution in accordance with department and health plan standards. Ensures that all pended claims are adjudicated within 30 days of their original pend date. o Initiates release of pended claims when needed Minimum Requirements: High school diploma or GED required. Prior customer service experience in a Claims processing environment. Minimum of three years prior work experience as a claim analyst, preferably in commercial healthcare, managed care, and/or AHCCCS related lines of business. Special Skills: Must be highly organized, professional, and have excellent verbal communication skills, particularly on the telephone. Should be proficient in ICD-9, CPT, and HCPCS coding; strong 10-key data entry and general numerical analytical skills required. Must be proficient with claims processing systems.
Posted on: Fri, 20 Sep 2013 16:52:47 +0000
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