Claims Correspondence Review Specialist

Imagine360•,

21h•$20 - $22•Remote

About The Position

Imagine360 is seeking a Claims Correspondence Review Specialist to join the team! This role of Client Claims Review (CCR) Specialist is a client facing role assisting the client by answering questions and resolving issues related to claims. The position performs research to accurately respond to inquiries from both internal and external customers. This position maintains a comprehensive understanding of the plan document(s) under their scope of responsibility. Position Location: 100% remote

Requirements

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

Responsibilities

Understand and review claims processing.
Interpret plan documents.
Review, research, and analyze information to determine eligibility.
Perform outbound telephone calls to assist in obtaining the required information to process a claim.
Work with the Claims Examiner to resolve claims processing issues
Provide acknowledgement and resolution to email questions within 8 hours or, provide customer with ETA and explanation for delay. When resolution cannot be completed in 8 hours, an ETA will be provided.
Respond to and resolve urgent issues in a timely manner.
Answer phone calls from the CSR team and Account management
Regularly checks and prioritize voicemails on an hourly basis and reply in a timely manner (no more than 8 hours).
Act as a role model in demonstrating the core values in customer service delivery.
Provide timely and thorough follow up with, internal and external customers.
Track and return telephone calls/mail to members and groups answering specific plan/claim questions within 24 hours.
Perform self-quality monitoring to develop and execute plans to meet established goals.
Recognize and notify appropriate supervisor of trends within their scope of responsibility that fall outside of quality parameters.
Collaborate with others and cross-departmentally to improve or streamline procedures

Benefits

Multiple Health plan options
Company paid employee premiums for disability and life insurance
Parental Leave Policy
20 days PTO to start
10 Paid Holidays
Tuition reimbursement
401k Company contribution
Company paid Short & Long term Disability plus Life Insurance
Professional development initiatives / continuous learning opportunities
Opportunities to participate in and support the company's diversity and inclusion initiatives