West Virginia Licensed Healthcare Customer Service Rep

A company is looking for a Healthcare Customer Service Rep II to provide member services 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, assist with prior authorizations, and conduct provider contact research Answer claims inquiries, provide status updates, and assist with reconsideration requests for denied claims Required Qualifications High School Diploma or GED required 2-3 years of experience in claims examination, health insurance, customer service, or a related healthcare field In-depth knowledge of healthcare terminologies, ICD-9 and ICD-10 coding, and policy process flows Must be able to clear a criminal background check Strong computer skills, including data entry and screen navigation

Mar 19, 2025 - 23:20

A company is looking for a Healthcare Customer Service Rep II to provide member services 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, assist with prior authorizations, and conduct provider contact research Answer claims inquiries, provide status updates, and assist with reconsideration requests for denied claims Required Qualifications High School Diploma or GED required 2-3 years of experience in claims examination, health insurance, customer service, or a related healthcare field In-depth knowledge of healthcare terminologies, ICD-9 and ICD-10 coding, and policy process flows Must be able to clear a criminal background check Strong computer skills, including data entry and screen navigation