Medicare Claims Support Specialist

Integrity Marketing Group; Clearwater (FL); On-site; USD 42,000 - 65,000; Full time

Job summary

Integrity Marketing Group in Clearwater, FL is seeking a Claims Specialist to review, process, and resolve inquiries about contract benefits and Medicare-related claims. You will document interactions, provide status updates, and ensure accurate policy files.

The role emphasizes clear communication with policyholders, agents, providers, and internal teams, maintaining a professional, customer-focused approach.

Qualifications

• High School Diploma or GED equivalent.
• 2-4 years of experience in a fast-paced call center or relevant experience.
• Preferred experience in medical insurance, especially Medicare Supplement plans.
• Strong communication skills, both verbal and written.
• Ability to clearly explain complex information in a customer-friendly manner.
• Proficient in claims systems and Microsoft Office applications.

Responsibilities

• Accurately interpret contract benefits and communicate details to policyholders, agents, and providers in a positive, professional manner.
• Provide clear and timely claim status updates to policyholders and providers.
• Prepare, send, and follow up on refund request letters as necessary.
• Create and deliver correspondence to customers as needed.
• Answer incoming calls and place outbound calls to provide or obtain information, ensuring all interactions are helpful, professional, and timely.
• Document all calls while in progress and fully update policy files or imaging systems to maintain a clear audit trail.
• Transfer calls to appropriate departments to ensure customer needs are met efficiently.
• Actively participate in cross-training and group training sessions to enhance team efficiency and uphold service standards.
• Maintain open communication with supervisors, team leads, and colleagues to ensure accurate responses and prevent duplication of efforts.
• Perform other duties as assigned to support the needs of the team.

Skills

Strong communication

Customer service experience

Attention to detail

Microsoft Office proficiency

Education

High School Diploma or GED

Job description

Integrity Marketing Group in Clearwater, FL is seeking a Claims Specialist to review, process, and resolve inquiries about contract benefits and Medicare-related claims. You will document interactions, provide status updates, and ensure accurate policy files.

The role emphasizes clear communication with policyholders, agents, providers, and internal teams, maintaining a professional, customer-focused approach.