Claims Customer Service Representative

Decatur, Illinois
Administrative & Support Services (Office and Administrative Support Occupations)
Job Type
US$ 14.00 per hour
Ref. Number
Kelly Bacuita, Spherion
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Job Description

Customer Service/Administrative 60%
Provides exceptional customer service for incoming phone calls to administration. Greets members
professionally and accurately ascertains problems or reasons for calling.
Resolves basic member inquiries by providing accurate, valid and complete information to callers by
using appropriate resources.
Follows procedures, guidelines and policies of the organization.
Opens, sorts and distributes daily mail.
Serves as back up for Membership Administrative Clerk. Providing coverage for servicing members is
an essential function of this position.
Claims Support 40%
Retrieves and prints daily attachments and distributes as necessary.
Enters medical pre-certifications into claims processing system.
Retrieves and prints daily faxes for team.
Screens claims to ensure a W-9 is on file. Sends request for W9, tracks requests and files form when
Scans information into claims processing system in a timely manner.
Checks claims processing system for duplicate claims for paper claims received.
Enters information from accident injury forms into claims processing system when received.
Prepares requests for Explanation of Benefits for Medicare paper claims.
Handles member inquiries regarding claims when possible or directs to appropriate staff.
Processes claims as directed.
Prepares correspondence for mailing.
Other Duties as Assigned.

Working hours: 8 am to 4:30 pm, Mon-Fri

1. Strong interpersonal skills, phone contact handling skills and active listening
2. Ability to remain professional and courteous with members at all times, adapting to different types of
3. Detail oriented with ability to multi-task, prioritize and manage time effectively, and willingness to adapt
to change
4. Excellent verbal and written communication skills
5. MS Windows and Office (Word, Excel, Outlook)
6. Experience with standard office equipment (scanner, fax, copier)
7. Basic knowledge of office practices and procedures
8. Data entry skills
9. Ability to follow routine written and oral instructions

Spherion has helped thousands of people just like you find work happiness! Our experienced staff will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temp-to-perm or direct hire opportunities, no one works harder for you than Spherion. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.

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