Healthcare Claims Customer Service Representative

Vaco has partnered with a well-established insurance organization to fill a Customer Service Representative role supporting policyholders and providers. This position serves as a primary point of contact for high-volume inbound inquiries, delivering accurate information, resolving issues efficiently, and ensuring an exceptional customer experience. The ideal candidate will have strong knowledge of Medicare Supplement insurance and claims adjudication processes, with a focus on achieving one-call resolution. If you are a detail-oriented, empathetic professional with insurance industry experience-apply today. ResponsibilitiesHandle high-volume inbound calls from policyholders and providers, delivering prompt and professional serviceProvide accurate and detailed information regarding insurance policies, benefits, coverage, and claimsResolve customer concerns efficiently, striving for one-call resolution whenever possibleAssist providers with claim processing, including claim submission guidance and clarification of reimbursement proceduresDemonstrate knowledge of Medicare Supplement insurance and healthcare claim adjudication processesEducate customers on claim determinations, policy provisions, and CMS-related guidelinesMaintain accurate documentation of all customer interactions within customer service systemsCollaborate with Claims Examiners and other internal departments to ensure timely and seamless issue resolutionIdentify and escalate complex inquiries appropriatelyUphold company standards of accuracy, integrity, empathy, and professionalism in every interactionStay current on CMS guidelines, Medicare Supplement updates, and internal policy changesQualificationsHigh school diploma or equivalent requiredMinimum 3 years of customer service experience, preferably in the insurance or healthcare industryStrong knowledge of Medicare Supplement insurance and healthcare claim adjudication processes preferredExperience handling high-volume inbound calls with a focus on first-call resolutionExcellent verbal and written communication skillsDetermining compensation for this role (and others) at Vaco/Highspring depends upon a wide array of factors including but not limited to the individual's skill sets, experience and training, licensure and certifications, office location and other geographic considerations, as well as other business and organizational needs. With that said, as required by local law in geographies that require salary range disclosure, Vaco/Highspring notes the salary range for the role is noted in this job posting. The individual may also be eligible for discretionary bonuses, and can participate in medical, dental, and vision benefits as well as the company's 401(k) retirement plan.Equal Opportunity NoticeHighspring LLC (d/b/a Vaco by Highspring) and its parents, affiliates, and subsidiaries ("we," "our," or "Vaco by Highspring") are committed to the full inclusion of all qualified individuals and does not discriminate against any employee or applicant for employment because of race (including but not limited to traits historically associated with race such as hair texture and hair style), color, sex (includes pregnancy or related conditions), religion or creed, national origin, citizenship, age, disability, status as a veteran, union membership, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, political affiliation, or any other protected characteristics as required by applicable law. The company is also committed to ensuring that persons who need them are provided with reasonable accommodations; if an accommodation is needed to participate in the job application or interview process, please contact HR@vaco.com .Vaco by Highspring also wants all applicants to know their rights that workplace discrimination is illegal.Representation NoticeBy submitting to this position, you agree that you will be giving Vaco by Highspring the exclusive right to present your as a candidate for the foregoing employment opportunity. Additionally, you agree to be included in our talent pool for future hiring for similarly qualified positions. You further agree that you have represented information about yourself accurately and have not affirmatively misrepresented your qualifications. Lastly, you agree to maintain as confidential, to the fullest extent permitted by law, any information you learn from Vaco by Highspring about the position and you will limit disclosure of information about the position only to the extent necessary to perform any obligations in furtherance of your application. In exchange, Vaco by Highspring agrees to exercise reasonable efforts to represent you through all solicitation, job screening and resume dispersal.For residents of Ontario, Canada only: to the extent the position for employment is not with Highspring or not otherwise noted as vacant above, candidate should be informed that this role is to replace a presently employed person at Vaco by Highspring's client.Privacy NoticeVaco by Highspring respects your privacy and are committed to providing transparent notice of our policies.California residents may access Vaco by Highspring HR Notice at Collection for California Applicants and Employees here.Virginia residents may access our state specific policies here.Residents of all other states may access our policies here.Canadian residents may access our policies in English here and in French here.Residents of countries governed by GDPR and UK GDPR may access our policies here.Additionally, submissions to this position are subject to the use of AI to perform preliminary candidate screenings, focused on ensuring minimum job requirements noted in the position are satisfied. More details about Vaco by Highspring's use of AI can be found here (https://www.highspring.com/ai-use-notices/). Further assessment of candidates beyond this initial phase will be conducted by recruiters and hiring managers. Vaco by Highspring does not know and cannot opine on if its client's use of AI products in hiring.Pay Transparency NoticeDetermining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to:· the individual's skill sets, experience and training;· licensure and certification requirements;· office location and other geographic considerations; and· other business and organizational needs.With that said, as required by local law, Vaco by Highspring believes that the following salary range referenced above reasonably estimates the base compensation for an individual hired into this position in geographies that require salary range disclosure. The individual may also be eligible for discretionary bonuses and/or participation in medical, dental, and vision benefits as well as the company's retirement plan (or similar retirement benefits).