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in Columbia, SC
Claims Customer Service Representative
Hours | Full-time, Part-time |
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Location | Columbia, South Carolina 29201 Columbia, South Carolina |
About this job
Aerotek is hiring Claims Customer Service Representatives for a health insurance company here in Columbia, SC. This individual will be responsible for responding to routine inquiries from members, reviewing and adjudicating claims and/or non-medical appeals and determining whether to return, deny or pay claims following organizational processes and procedures.
Responsibilities of Job:
- Responds to written and/or telephone inquires according to desk procedures, ensuring that contract standards and objectives for timeliness, productivity and quality are met.
- Accurately documents inquiries in computer system
Identifies incorrectly processed claims and process adjustments and reprocessing actions according to department guidelines. - Examines and process claims and/or non-medical appeals according to business/contract regulations, internal standards and examining guidelines.
- Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes.
- Ensures claims are processing according to established quality and production standards.
- Identifies complaints and inquiries of a complex level that cannot be resolved following desk procedures and guidelines and refers these to a lead or manager for resolution.
- Identifies and promptly reports and/or refers suspected fraudulent activities and systems errors to the appropriate departments.
Shift: Monday - Friday, first and second shift available
Pay: $13/hour
About Aerotek:
Our people are everything. As a Best of Staffing® Client and Talent leader, Aerotek® Inc. has distinguished itself as a leader in recruiting and staffing services, by having a deep understanding of the intersection of talent and business. As a strategic partner to more than 17,000 clients and 300,000 contract employees every year, Aerotek's people-focused approach yields competitive advantages for its clients and rewarding careers for its contract employees. Headquartered in Hanover, Md., Aerotek operates a network of over 230 non-franchised offices with more than 6,000 internal employees dedicated to serving our customers. Aerotek is an operating company of Allegis Group, a global talent solutions provider. To learn more, visit .
Aerotek is acting as an Employment Agency in relation to this vacancy.