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Provider Claims Customer Service Jobs

Claims Customer Service Coordinator
By BlueCross BlueShield of South Carolina At Columbia, SC, United States
Identifies issues with procedures and processes and provides feedback to management on changes and development.
Continuing education funds for additional certifications and certification renewal
You will have to work on site as needed if remote access is granted.
Trains new employees and introduces new material to all employees. Develops, updates, and maintains procedural manuals.
High School Diploma or equivalent
401(k) retirement savings plan with company match
Customer Service - Claims (Property)
By USAA At , Phoenix, 85085
US military experience through military service or a military spouse/domestic partner
For more details on our outstanding benefits, visit our benefits page on USAAjobs.com.
Provide claims service via internal channels (phone/fax/email/mail)to members and third-party customers.
Adjust low to moderately intricate Property claims.
Seek mentorship from team members to resolve issues and identify appropriate issues for additional review.
Partner with and advises vendors and business partners to facilitate claims resolution.
Systems Engineer Service Provider
By Palo Alto Networks At , $187,500 - $257,850 a year
Experience selling, implementing, or managing SaaS/SASE/cloud/managed/on-prem offerings is a plus
Demonstrating strong communication skills and the ability to influence through effective presentations and customer-specific demos, technical engagements, and workshops
Meeting and exceeding sales quotas by building and implementing strategic, technical account plans that target cross-platform solutions
Conducting discovery to understand and articulate the key technical, operational, and commercial imperatives of your prospects and customers
Planning and building compelling technical and business-focused solutions which drive adoption and growth after the initial sale and across the portfolio
Orchestrating supporting resources to ensure a one-team approach that demonstrates a cohesive strategy
Systems Engineer Service Provider
By Palo Alto Networks At , Atlanta, Ga $187,500 - $257,850 a year
Experience selling, implementing, or managing SaaS/SASE/cloud/managed/on-prem offerings is a plus
Demonstrating strong communication skills and the ability to influence through effective presentations and customer-specific demos, technical engagements, and workshops
Meeting and exceeding sales quotas by building and implementing strategic, technical account plans that target cross-platform solutions
Conducting discovery to understand and articulate the key technical, operational, and commercial imperatives of your prospects and customers
Planning and building compelling technical and business-focused solutions which drive adoption and growth after the initial sale and across the portfolio
Orchestrating supporting resources to ensure a one-team approach that demonstrates a cohesive strategy
Customer Service Claims Representative
By Amica Mutual Insurance Company At , Lincoln, 02865, Ri
Strong organizational, time management and priority-setting skills
Committed to improving one’s professional knowledge through continuing education
Strong written and verbal communication skills
Solid decision making skills, ability to handle conflicts and deal with difficult situations
Knowledge of Microsoft Office and computer systems
Secure and maintain licenses in designated states and complete continuing education as needed for compliance.
Claims Customer Service Supervisor
By BlueCross BlueShield of South Carolina At Columbia, SC, United States
Knowledge of the benefit plans for each group.
Bachelor's degree OR 4 years of healthcare experience in customer service, provider network service, membership, billing, and/or claims/appeals processing operations.
2 years of claims/appeals, customer service, or call center experience.
Strong analytical, organizational, and judgement skills.
Strong oral and written communication skills.
Strong spelling, punctuation, and grammar skills.
Claims Customer Service - Remote | Wfh
By Get It Recruit - Real Estate At Des Moines, IA, United States

Are you eager to embark on an exciting contract role in administration? This outstanding opportunity might just be the perfect fit for you! We've teamed up with a highly reputable client in search of ...

Remote Service Provider Jobs
By Channelz At United States

Channelz is a dynamic online platform that connects individuals worldwide with experts in various fields. We offer an extensive range of interests and services, catering to diverse needs and ...

Supervisor, Claims Customer Service
By BlueCross BlueShield of South Carolina At Columbia, SC, United States
Knowledge of the benefit plans for each group
Bachelor's degree or 4 years of healthcare experience in customer service, provider network service, membership, billing, and/or claims/appeals processing operations
2 years of claims/appeals, customer service, or call center experience
Strong analytical, organizational, and judgment skills
Strong oral and written communication skills
Strong spelling, punctuation, and grammar skills
Provider Claims Customer Service
By CVS Health At , , Va $17.00 - $27.90 an hour

Answers questions and resolves issues based on phone calls/letters from members, providers, and plan sponsors. Triages resulting rework to appropriate staff. Provide excellent customer services for ...

Customer Service - Claims (Property)
By USAA At , San Antonio, 78288, Tx
US military experience through military service or a military spouse/domestic partner
For more details on our outstanding benefits, visit our benefits page on USAAjobs.com.
Provide claims service via internal channels (phone/fax/email/mail)to members and third-party customers.
Adjust low to moderately intricate Property claims.
Seek mentorship from team members to resolve issues and identify appropriate issues for additional review.
Partner with and advises vendors and business partners to facilitate claims resolution.
Customer Service - Claims (Auto)
By USAA At , Tampa, 33647, Fl
US military experience through military service or a military spouse/domestic partner
For more details on our outstanding benefits, visit our benefits page on USAAjobs.com.
Provide claims service via internal channels (phone/fax/email/mail)to members and third-party customers.
Adjust low to moderately intricate Auto or Property claims.
Seek mentorship from team members to resolve issues and identify appropriate issues for additional review.
Partner with and advises vendors and business partners to facilitate claims resolution.
Coordinator, Claims Customer Service
By BlueCross BlueShield of South Carolina At Columbia, SC, United States
Respond accurately and timely to inquiries from team members, including management, concerning customer inquiries, claims adjudication, appeals and other technical issues
Identify issues with procedures and processes and provides feedback to management on changes and development
Excellent verbal and written communication skills
Knowledge of claims processing procedures
Investigate and initiate resolutions to complex problems
Authorize payment recovery, claim payments, or makes claim rejections based on documented information and provisions of state or federal law
Provider Customer Service Team Lead - National Remote
By UnitedHealth Group At , Dallas, 75202, Tx $18.80 - $36.78 an hour
Maintains proficiency in all technical applications (technical skills and system knowledge)
Assists supervisor in monitoring employee and team performance by reviewing operational metrics and listening to and observing call management techniques.
2+ years of experience in an advocate role, with Buffalo care intake experience
Previous experience mentoring and/or training others
Experience with personal computer and Windows PC applications Microsoft Excel
Experience with personal computer and Windows PC applications Microsoft Word
Fcmb Claims Customer Service Advocate Ii
By BlueCross BlueShield of South Carolina At Florence, SC, United States
A proven curriculum providing the knowledge you need to excel.
Our Comprehensive Benefits Package Includes
Best-in-class call center training program.
Peer coach to observe you.
Peer coach for you to observe.
A training lab where you take live calls with a training supervisor close by to answer questions.
Provider Claims Education Manager (Medicaid)
By Humana At Indianapolis, IN, United States
Ensures compliance with Indiana’s Managed Care Contractual requirements for provider relations, such as claims dispute resolution within specified timeframes.
Manages teamwork assignments to ensure adequate coverage to meet quality and service levels.
Five (5) years of technical experience with claims systems, adjudication, submission processes, coding, dispute resolution, and/or other related function.
Two (2) years of progressive leadership experience.
Experience reviewing and analyzing large sets of claims data.
Experience working for or with key provider types: primary care, FQHCs, hospitals, nursing facilities, and/or HCBS and LTSS providers.
Provider Claims Customer Service
By CVS Health At , , Ks $17.00 - $27.90 an hour

Answers questions and resolves issues based on phone calls/letters from members, providers, and plan sponsors. Triages resulting rework to appropriate staff. Provide excellent customer services for ...

Provider Claims Customer Service
By CVS Health At , , Fl $17.00 - $27.90 an hour

Answers questions and resolves issues based on phone calls/letters from members, providers, and plan sponsors. Triages resulting rework to appropriate staff. Provide excellent customer services for ...

Provider Non-Contracted Appeals And Claims Analyst
By Mediant Health Resources At Los Angeles, CA, United States
Proven problem-solving skills and ability to translate knowledge to the department
3+ years’ experience processing Medicare Advantage provider appeals from all types of providers (hospitals, physicians, ancillary)
3+ years’ experience in examining all types of medical claims, preferably Medicare Advantage claims
Working knowledge of claims processing systems (EZCAP preferred)
Working knowledge of medical terminology, standard coding and reference publications, CPT, HCPC, ICD-9, ICD-10, DRG, etc.
Familiarity with billing and coding edits, coordination of benefits, MA Organization, Determination, Appeals and Grievance procedures
Provider Claims Customer Service
By CVS Health At , , Tx $17.00 - $27.90 an hour

Answers questions and resolves issues based on phone calls/letters from members, providers, and plan sponsors. Triages resulting rework to appropriate staff. Provide excellent customer services for ...