Claims Correspondence Review Specialist

Imagine360•,

33d•$20 - $22•Remote

About The Position

Imagine360 is seeking a Claims Correspondence Review Specialist, also referred to as a Client Claims Review (CCR) Specialist. This client-facing role assists clients by answering questions and resolving issues related to claims. The specialist researches inquiries to provide accurate responses and maintains a comprehensive understanding of the plan documents within their scope of responsibility. The position is 100% remote.

Requirements

High school diploma or equivalent.
2 years of claims examiner and/or customer service experience.
Proficient 10-key and typing skills.
Self-motivation, organizational skills, and problem-solving skills.
Strong written and oral communication skills, with attention to detail and accuracy.
Ability to remain neutral and maintain confidentiality.

Responsibilities

Understand and review claims processing.
Interpret plan documents.
Review, research, and analyze information to determine eligibility.
Make outbound telephone calls to obtain information required to process claims.
Work with Claims Examiners to resolve claims processing issues.
Acknowledge and resolve email questions within 8 hours, or provide an estimated response time and explanation for delays.
Respond to and resolve urgent issues in a timely manner.
Answer calls from the CSR team and Account Management.
Check and prioritize voicemails hourly and respond in a timely manner, no more than 8 hours later.
Demonstrate the company's core values in customer service delivery.
Provide timely and thorough follow-up to internal and external customers.
Track and return telephone calls and mail to members and groups, answering specific plan and claim questions within 24 hours.
Perform self-quality monitoring and develop and execute plans to meet established goals.
Recognize and notify the appropriate supervisor about trends in the specialist's area of responsibility that fall outside quality parameters.
Collaborate with others and across departments to improve or streamline procedures.

Benefits

Multiple health plan options.
Company-paid employee premiums for disability and life insurance.
Parental leave policy.
20 days of PTO to start.
10 paid holidays.
Tuition reimbursement.
401(k) company contribution.
Company-paid short- and long-term disability, plus life insurance.
Professional development initiatives and continuous learning opportunities.
Opportunities to participate in and support the company's diversity and inclusion initiatives.