Claims Representative

LHH; Brookhaven (GA); On-site; USD 40,000 - 55,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) plan

Paid leave

Job summary

LHH seeks a Customer Service Representative to join a growing team delivering exceptional support to policyholders and healthcare providers in a fast-paced environment.

You will handle high-volume inbound calls, provide accurate policy/benefit information, and resolve issues with a focus on first-call resolution, while supporting claims processing and CMS guideline adherence.

Qualifications

• Experience handling high-volume inbound customer calls.
• Knowledge of Medicare Supplement insurance and healthcare claims adjudication processes.
• Strong customer service background with a focus on problem resolution.

Responsibilities

• Handle a high volume of inbound calls from policyholders and providers, provide accurate information regarding policies, benefits, coverage and claims.
• Assist customers and providers with claims-related inquiries and claim status updates; support submission processes and clarify reimbursement procedures.
• Maintain accurate records of customer interactions and transactions; escalate complex issues while maintaining service quality.

Skills

High-volume calls handling

Medicare knowledge

Customer service

Communication skills

CRM systems

Education

High school diploma or equivalent

Tools

CRM software

Customer service software

Job description

LHH is seeking a Customer Service Representative to join a growing team focused on providing exceptional support to policyholders and healthcare providers.

This position is ideal for someone who thrives in a fast-paced environment, enjoys problem-solving, and has experience supporting customers with insurance-related inquiries, claims, and benefits. The successful candidate will play a key role in delivering accurate information, resolving concerns efficiently, and creating a positive customer experience.

What You'll Do

Customer Service

• Handle a high volume of inbound calls from policyholders and providers.
• Provide accurate information regarding insurance policies, benefits, coverage, and claims.
• Resolve customer concerns promptly with a strong focus on first-call resolution.
• Deliver professional, empathetic, and solution-oriented customer service.

Claims Support

• Assist customers and providers with claims-related inquiries and claim status updates.
• Support claim submission processes and clarify reimbursement procedures.
• Educate customers on policy details, benefits, and claims processes.
• Ensure compliance with Medicare and applicable industry guidelines.

Daily Operations

• Maintain accurate records of customer interactions and transactions.
• Collaborate with claims teams and other departments to ensure seamless service delivery.
• Escalate complex issues when necessary while maintaining a positive customer experience.
• Support continuous improvement initiatives and service excellence standards.

Professional Development

• Stay current on Medicare Supplement insurance, healthcare claims processing, CMS regulations, and industry trends.

Qualifications

Experience

• Experience handling high-volume inbound customer calls.
• Knowledge of Medicare Supplement insurance and healthcare claims adjudication processes.
• Strong customer service background with a focus on problem resolution.

Skills

• Exceptional verbal and written communication skills.
• Strong interpersonal and relationship-building abilities.
• Excellent problem-solving and critical-thinking skills.
• High attention to detail and accuracy.
• Ability to multitask and prioritize in a fast-paced environment.
• Experience using customer service software, databases, and CRM systems.
• Ability to work independently and collaboratively within a team environment.

Education

• High school diploma or equivalent required.

Ideal Candidate

• Customer-focused and empathetic
• Strong communicator and active listener
• Detail-oriented and organized
• Comfortable in a high-volume call environment
• Knowledgeable in healthcare insurance and claims processes
• Team player with a positive, professional attitude

• Full Time
• In-Office
• Direct Hire

If you're looking for an opportunity to make a meaningful impact while building your career in customer service and insurance operations, we'd love to hear from you!

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Equal Opportunity Employer/Veterans/Disabled

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy

The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:

The California Fair Chance Act

Los Angeles City Fair Chance Ordinance

Los Angeles County Fair Chance Ordinance for Employers

San Francisco Fair Chance Ordinance

Benefit offerings include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits, and 401K plan. Our program provides employees the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria.