Remote Healthcare Claims Support Specialist

Fresno PACE; Fresno (CA); Remote; USD 26,000 - 32,000; Full time

Benefits offered by this job

401(k)

Dental insurance

Health insurance

Paid time off

Flexible spending account

Life insurance

Paid sick time

Referral program

Retirement plan

Vision insurance

Job summary

The Claims Customer Service Representative (CCSR) at Innovative Integrated Health, Inc. serves as a critical liaison between the Company and external providers.

The CCSR handles incoming inquiries from Providers who submit claims and must act with professionalism and confidentiality in a fast-paced environment. This entry-level role requires strong communication, attention to detail, HIPAA compliance, and the ability to multitask remotely.

Qualifications

• Minimum of two years of work experience required.
• Healthcare call center experience preferred.
• Remote work experience preferred.
• High School Diploma or GED required.
• Knowledge of HIPAA privacy requirements.

Responsibilities

• Respond to Provider inquiries regarding medical and dental claims via phone and email.
• Research and resolve issues related to claims status, denials, and payment discrepancies.
• Maintain up-to-date knowledge of benefit plans, claim adjudication guidelines, coding requirements, and HIPAA regulations.
• Accurately document all interactions and claim actions in the Company system by compliance standards.
• Maintain accurate records of interactions and claim resolutions.
• Communicate complex benefit details in a clear and concise manner to Providers.
• Collaborate with internal departments to facilitate resolution of claims-related issues.
• Recommend process improvements to enhance service delivery and Provider experience.

Skills

Microsoft Office Suite

Medical billing terminology

Strong communication

Multi-tasking

Education

High School Diploma or GED

Tools

Claims processing software

Job description

The Claims Customer Service Representative (CCSR) at Innovative Integrated Health, Inc. serves as a critical liaison between the Company and external providers.

The CCSR handles incoming inquiries from Providers who submit claims and must act with professionalism and confidentiality in a fast-paced environment. This entry-level role requires strong communication, attention to detail, HIPAA compliance, and the ability to multitask remotely.