Medical Claims Customer Service Representative

TEKsystems • Enfield, CT

2d • Remote

About The Position

This is a high-volume, fast-paced role where you will be on calls and entering claims. You’ll need to know your stuff and move quickly. This role is a Contract to Hire position. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

Requirements

• Supplemental health claims: Accident, Critical Illness, Hospital Indemnity
• Strong knowledge of: CPT / HCPCS, ICD-10, Revenue cycle basics
• Ability to read and understand: HCFA 1500, UB04, EOBs / medical records
• 1–2+ years in health insurance claims
• 1+ year call center experience (remote preferred)

Nice To Haves

• Denials or appeals
• Claims intake or processing
• Medical billing / revenue cycle work
• Insurance carrier or TPA experience

Responsibilities

• Handle 40–50 inbound calls/day
• Review & break down medical claims and benefits
• Work with HCFA 1500, UB04, EOBs, medical records
• Enter 20 claims/day (accuracy matters)
• Use CPT, HCPCS, ICD-10 codes daily
• Help customers understand and move claims forward fast

Benefits

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

What This Job Offers

• Career Level: Entry Level
• Education Level: No Education Listed
• Number of Employees: 501-1,000 employees