Entry-Level Client Resolution Specialist – Healthcare Claims

WebTPA Employer Services, LLC; San Antonio (TX); On-site; USD 32,000 - 45,000; Full time

Job summary

WebTPA Employer Services, LLC in San Antonio, TX is seeking an entry-level Client Resolution Specialist to handle inbound calls from providers and members, focusing on resolving client-related issues and offering expert-level resolutions.

You will be the primary contact for claims and customer service issues for assigned accounts, work between 7:00am and 7:00pm CST, Monday to Friday, and collaborate with Benefit Consultants to resolve complex cases.

Qualifications

• 1+ years related work experience in customer service.
• Knowledge in the healthcare industry including CPT and ICD-10 coding, COBRA, HIPAA.
• Concise written and oral communication skills.
• Proficiency in maintaining good rapport with physicians, healthcare facilities, clients and providers.
• Must possess proven judgment, decision-making skills and the ability to analyze.

Responsibilities

• Provide standard client support and be primary client contact for claims and customer service issues for assigned accounts.
• Utilize systems to track all assigned client questions or concerns and assist with calls and queues.
• Provide expert level assistance to members with complex or escalated issues and work with Benefit Consultant to resolve claims or service issues.
• Research claim appeals, research benefit questions, and locate network providers as needed.
• Provide instruction and training to Customer Service Team when directed by the employer group or Customer Service Manager.

Skills

Customer service

Communication

Conflict resolution

Team collaboration

Decision making

Education

High school diploma or GED

Tools

MS Office

Job description

WebTPA Employer Services, LLC in San Antonio, TX is seeking an entry-level Client Resolution Specialist to handle inbound calls from providers and members, focusing on resolving client-related issues and offering expert-level resolutions.

You will be the primary contact for claims and customer service issues for assigned accounts, work between 7:00am and 7:00pm CST, Monday to Friday, and collaborate with Benefit Consultants to resolve complex cases.