Claims Customer Service Representative

About the role

Vaco is partnering with an established insurance organization in Atlanta, GA, to hire a Claims Customer Service Representative. This opportunity is ideal for a customer service professional with experience in healthcare, insurance, medical claims, or high-volume inbound calls.

Responsibilities

• Handle high-volume inbound calls from policyholders and providers, answering questions regarding insurance policies, benefits, coverage, and claims.
• Resolve issues with a focus on one-call resolution.
• Assist with claim submissions and reimbursement questions.
• Explain claims adjudication processes and policy details.
• Maintain accurate customer records.
• Research and escalate complex issues.
• Collaborate with internal teams to ensure a seamless customer experience.

Requirements

• High school diploma or equivalent.
• Experience handling high-volume inbound customer service calls.
• Knowledge of healthcare claim adjudication processes.
• Strong customer service skills with a focus on one-call resolution.
• Excellent verbal and written communication skills.
• Professional and clear communication style.
• Strong problem-solving and attention-to-detail skills.
• Able to manage and prioritize multiple tasks in a high-volume environment.
• Insurance, healthcare, or medical experience preferred.
• Medical claims experience preferred.
• Knowledge of Medicare Supplement insurance and CMS guidelines preferred.
• Claims adjudication experience preferred.

Desired Skills and Experience

• High school diploma or equivalent.
• Experience handling high-volume inbound customer service calls.
• Knowledge of healthcare claim adjudication processes.
• Strong customer service skills with a focus on one-call resolution.
• Excellent verbal and written communication skills.
• Professional and clear communication style.
• Strong problem-solving and attention-to-detail skills.
• Able to manage and prioritize multiple tasks in a high-volume environment.
• Insurance, healthcare, or medical experience preferred.
• Medical claims experience preferred.
• Knowledge of Medicare Supplement insurance and CMS guidelines preferred.
• Claims adjudication experience preferred.

Pay, Benefits & Schedule

Determining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to the individual's skill sets, experience and training, licensure and certifications, office location and other geographic considerations, as well as other business and organizational needs. With that said, as required by local law in geographies that require salary range disclosure, Vaco by Highspring notes the salary range for the role is noted in this job posting. The individual may also be eligible for discretionary bonuses, and can participate in medical, dental, and vision benefits as well as the company's 401(k) retirement plan.