Claims Customer Service Representative

This is a fully remote position, open to applicants in Texas.

📋 Description

• Manage an average of 40–50 customer service calls daily

• Deliver timely, precise, and customer-centric information regarding benefits and claims

• Gather and input necessary information to ensure accurate and prompt claim processing

• Document detailed summaries of all information exchanged in the claims system

• Issue timely and precise claim acknowledgment correspondence

• Process incoming documents with high coding accuracy and distribute them without delay

• Collaborate with a financial client through TEKsystems

⛳️ Requirements

• Experience with supplemental health claims

• Familiarity with CPT/HCPCS/REV/ICD-10 codes and insurance billing forms for providers/facilities

• 1–2+ years of experience in health insurance claims and benefits, specifically in Scheduled Accident, Critical Illness, or Hospital Indemnity

• At least 1 year of call center experience; remote call center experience is preferred

• Proficiency in reading medical claims forms, including HCFA 1500 and UB04

• Understanding of medical records and Explanation of Benefits (EOBs) is advantageous

• Knowledge of CPT codes is beneficial

• Availability to work Monday–Friday, from 10:30 a.m. to 7:00 p.m. CST

🏝️ Benefits

• Medical, dental, and vision insurance

• Coverage for Critical Illness, Accident, and Hospital expenses

• 401(k) Retirement Plan with options for pre-tax and Roth post-tax contributions

• Optional Life & AD&D insurance for employees and their dependents

• Short-term and long-term disability coverage

• Health Spending Account (HSA)

• Transportation benefits

• Employee Assistance Program

• Time Off/Leave options (PTO, Vacation, or Sick Leave)