Tennessee Licensed Healthcare Customer Service Rep

A company is looking for a Healthcare Customer Service Rep II, responsible for managing member services calls related to policy management, benefits, and claims inquiries. Key Responsibilities Process member payments, update member information, and handle policy terminations and reinstatements Provide accurate coverage information and assist with prior authorization and referral processes Offer claims status updates and assist members with claims inquiries and reconsideration requests Required Qualifications High School Diploma or GED required 2-3 years of experience in claims examination, health insurance, customer service, or a related field In-depth knowledge of healthcare terminology, eligibility, benefits, medical claims, and ICD-9/ICD-10 coding Must pass a criminal background check Strong computer skills and ability to work independently and as part of a team

Mar 14, 2025 - 01:14

A company is looking for a Healthcare Customer Service Rep II, responsible for managing member services calls related to policy management, benefits, and claims inquiries. Key Responsibilities Process member payments, update member information, and handle policy terminations and reinstatements Provide accurate coverage information and assist with prior authorization and referral processes Offer claims status updates and assist members with claims inquiries and reconsideration requests Required Qualifications High School Diploma or GED required 2-3 years of experience in claims examination, health insurance, customer service, or a related field In-depth knowledge of healthcare terminology, eligibility, benefits, medical claims, and ICD-9/ICD-10 coding Must pass a criminal background check Strong computer skills and ability to work independently and as part of a team