Responsibilities and duties
- Approve or reject health claims according to the SPD and plan guidelines.
- Complete data entry into Group+ to adjudicate claims charges.
- Perform appropriate correspondence via letter or telephone for claim completion.
- Answer inquiries regarding eligibility and confirmation of benefits for coverage of proposed services for TPA plans.
- Answer inquiries regarding status of claims payment for TPA plans.
- Document all customer service contacts.
- Perform other duties and assignments as requested by manager.
High school graduate.
- Medical and/or insurance background desirable.
- Medical coding knowledge helpful.
Skills and Abilities:
- Excellent verbal and written interpersonal and communication skills including high level of listening skills.
- Customer oriented with the ability to adapt and respond to different types of customers with sensitivity.
- Demonstrate positive leadership skills and take initiative.
- Ability to make quick and appropriate decisions despite interruptions.
- Flexibility with changing work patterns and/or varying workloads.
- Excel at problem solving.
- Attention to detail with the ability to multi-task and prioritize while managing time effectively.
- Proficient in use of Microsoft Office software.
- Ability to develop and maintain a strong sense of teamwork.
- Must be able to maintain call center hours.
No supervisory responsibilities
This is a full-time position
Everence Corporate office – Goshen, Indiana