Claims Research & Resolution Representative

📋 Description

• Handle inbound calls from members, providers, insurance companies, and other stakeholders
• Research and resolve moderately complex claims inquiries, including financial recovery
• Conduct outbound calls when necessary to follow up on cases, gather additional information, or
• Document inquiries, complaints, transactions, interactions, research findings, and actions taken
• Investigate pending claims and inquiries using available internal resources, systems, policies, and
• Escalate unresolved or pending issues appropriately while maintaining ownership of the customer

🎯 Requirements

• At least 1 year of call-center or telephone-based customer service experience gained within the
• Previous healthcare-related work experience or education.
• Basic proficiency with Microsoft Office applications, including Word, Excel, Outlook, and Teams.
• Strong technical skills and the ability to navigate and work across multiple software systems
• Ability to independently research and resolve issues using internal system resources and available
• Strong time-management and prioritization skills, with demonstrated ability to manage multiple or

🎁 Benefits

• Annual salary: $40,000–$52,300, with individual compensation varying based on location, skills
• Full-time schedule of 40 hours per week.
• Fully remote work opportunity within the United States.
• Comprehensive medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off, company holidays, and personal holidays.