Rx Claims Support Agent (Temp)

Southern-Scripts-LLC; Dallas (TX); On-site; USD 22,000 - 30,000; Part time

Job summary

Southern-Scripts-LLC in Dallas, TX is seeking a temporary Member Services Agent to deliver exceptional customer service for health-related programs. The role involves handling inquiries, processing claims information, and maintaining records with a strong emphasis on accuracy and HIPAA compliance.

You will work with internal teams to resolve issues, follow up on claims, and communicate clearly with customers.

Qualifications

• Knowledge of customer service principles and practices.
• Bachelors not required; HS diploma or equivalent acceptable.

Responsibilities

• Provide effective customer service for all internal and external customers by using knowledge of company products and programs.
• Maintain detailed records of customer interactions, inquiries, complaints, and actions taken.
• Follow up to ensure issues are resolved and changes implemented.
• Refer unresolved grievances to designated departments for investigation.
• Review Rx insurance policy terms to determine claim coverage for employer groups.
• Contact customers to respond to inquiries or notify them of investigation results or adjustments.
• Resolve service or billing complaints promptly and professionally.
• Obtain and examine information to assess validity of complaints and determine causes.
• Abide by HIPAA obligations related to PHI and report violations as required.
• Attend required HIPAA Training and maintain compliance.
• Role duties may change; flexibility and adaptability are essential.

Skills

Interacting with Computers

Communicating with Supervisors, Peers,

Getting Information

Communicating with Persons Outside

Processing Information

Resolving Conflicts and Negotiating

Updating and Using Knowledge

Organizing, Planning, and Prioritizing

Performing Administrative Activities

Making Decisions and Solving Problems

Time Management

Teamwork Orientation

Technical Capacity

Multitasking

Education

High School or equivalent

Job description

Southern-Scripts-LLC in Dallas, TX is seeking a temporary Member Services Agent to deliver exceptional customer service for health-related programs. The role involves handling inquiries, processing claims information, and maintaining records with a strong emphasis on accuracy and HIPAA compliance.

You will work with internal teams to resolve issues, follow up on claims, and communicate clearly with customers.