Sr. Call Center Claims Specialist

Ultimate Staffing; Burbank (CA); On-site; USD 58,000 - 65,000; Full time

Job summary

A leading staffing agency seeks a Call Center Claims Specialist in Burbank, California. This full-time role requires a bachelor's degree and 4+ years in a call center, preferably with claims processing experience. Responsibilities include handling high-volume calls, resolving claims inquiries, and maintaining customer satisfaction. Candidates should possess strong analytical skills, excellent communication abilities, and experience with medical terminology. The position offers a salary range of $58,000 to $65,000 annually.

Qualifications

• 4+ years of call center experience.
• Preferred 4 years of claims processing experience.
• Knowledge of medical terminology preferred.

Responsibilities

• Handle high-volume incoming calls regarding claims inquiries.
• Document information accurately to resolve customer issues.
• Process healthcare claims using multiple systems.
• Research claim-related problems and escalate if necessary.
• Maintain strong customer relationships through professional service.
• Meet performance metrics for quality and attendance.

Skills

Analytical and problem-solving abilities

Verbal and written communication skills

Proficiency in Microsoft Office Suite

Ability to manage multiple priorities

Education

Bachelor's degree

Job description

Call Center Claims Specialist

Base pay range: $58,000.00/yr - $65,000.00/yr

The Call Center Claims Specialist serves as a key customer service representative, handling incoming calls from participants, providers, and other stakeholders while processing health insurance claims. This role requires adherence to eligibility, claims, and call policies and procedures, ensuring accurate and timely resolutions. Responsibilities include answering inquiries, resolving issues, fulfilling requests, and maintaining performance standards in efficiency, accuracy, and customer satisfaction.

Key Responsibilities

• Answer high-volume incoming calls and assist with benefit, eligibility, billing, payment, and claims inquiries
• Document information accurately and communicate clearly with customers to resolve issues
• Process and review healthcare claims using multiple systems, ensuring proper application of benefits and compliance with policies
• Research and resolve claim-related problems, escalating when necessary
• Maintain strong customer relationships through professional and empathetic service
• Meet established performance metrics for quality, productivity, and attendance

Requirements

• Bachelor's degree required
• Minimum of 4 years of call center experience
• 4 years of claims processing experience preferred
• Knowledge of medical terminology preferred

Skills

• Strong analytical and problem‑solving abilities
• Excellent verbal and written communication skills
• Proficiency in Microsoft Office Suite
• Ability to work in a fast‑paced environment and manage multiple priorities

Desired Skills and Experience

We are seeking a candidate with a strong background in health insurance claims processing, customer service excellence, and a data‑driven approach to problem resolution. The ideal applicant will demonstrate expertise in medical terminology, a solid understanding of claim adjudication processes, and ability to work effectively under tight deadlines while maintaining high quality standards.

Seniority level: Mid‑Senior level

Employment type: Full‑time

Job function: Health Care Provider / Insurance and Employee Benefit Funds

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, and Los Angeles County Fair Chance Ordinance. For unincorporated Los Angeles county, to the extent our customers require a background check for certain positions, the Company faces a significant risk to its business operations and business reputation unless a review of criminal history is conducted for those specific job positions.