Claims Resolution Specialist II

TALENT Software Services; Myrtle Beach (SC); On-site; USD 30,000 - 50,000; Full time

Job summary

TALENT Software Services is seeking a detail-oriented individual for a customer service role focused on claims processing. Responsibilities include managing inquiries and adjudicating claims in line with organizational policies. Candidates should possess strong communication skills, customer service experience, and proficiency in Microsoft Office.

The position demands a high school diploma or equivalent, with preferences given to those with claims or appeals processing experience.

Qualifications

• 2 years of customer service experience including 1 year claims or appeals processing.
• Bachelor's Degree may substitute for work experience.

Responsibilities

• Respond to customer inquiries and resolve issues.
• Review and adjudicate claims and/or non-medical appeals.
• Ensure claims processing aligns with policies.
• Identify potential fraud and abuse.

Skills

Verbal and written communication skills

Customer service skills

Basic business math proficiency

Ability to handle confidential information

Education

High School Diploma or equivalent

Tools

Microsoft Office

Job description

TALENT Software Services is seeking a detail-oriented individual for a customer service role focused on claims processing. Responsibilities include managing inquiries and adjudicating claims in line with organizational policies. Candidates should possess strong communication skills, customer service experience, and proficiency in Microsoft Office.

The position demands a high school diploma or equivalent, with preferences given to those with claims or appeals processing experience.