Claims Customer Service Representative (Bilingual)
LHH, Atlanta, GA, United States
Claims Customer Service Representative (Bilingual)
We are seeking a Claims Customer Service Representative (Bilingual) for one of our clients over in Brookhaven, Ga. The Claims Customer Service Representative is responsible for handling high-volume inbound calls from policyholders and healthcare providers. This role focuses on resolving claim-related inquiries, providing accurate insurance information, and delivering excellent customer service with an emphasis on first-call resolution. Key Responsibilities
Handle a high volume of inbound customer service calls in a professional and efficient manner Respond to inquiries related to insurance policies, benefits, coverage, and claims Aim for first-call resolution while maintaining a positive customer experience Assist healthcare providers with claim processing and submission guidance Explain claim adjudication outcomes, reimbursement procedures, and policy details Ensure compliance with Medicare, CMS, and industry regulations Accurately document all customer interactions and claim-related activity Escalate complex or unresolved issues to the appropriate department Collaborate with internal teams to support efficient claims and service operations Required Qualifications
Strong knowledge of Medicare Supplement and other applicable insurance products Bilingual proficiency in English and Spanish required, with the ability to clearly communicate insurance and claims information to diverse audiences. Understanding of healthcare claim adjudication processes Experience in a high-volume inbound call environment Excellent verbal and written communication skills Strong problem-solving skills and attention to detail Ability to work independently and collaboratively within a team Proficiency with customer service systems, databases, and related tools Education
High school diploma or equivalent Skills & Competencies
Customer service excellence Empathy and patience with customers and providers Clear and effective communication Time management and multitasking in a fast-paced environment Attention to accuracy and documentation Adaptability to changing policies, guidelines, and procedures Location: Brookhaven, GA Job Type: Onsite | Direct Hire | Full-Time Pay Details: $45,000.00 to $50,000.00 per year
We are seeking a Claims Customer Service Representative (Bilingual) for one of our clients over in Brookhaven, Ga. The Claims Customer Service Representative is responsible for handling high-volume inbound calls from policyholders and healthcare providers. This role focuses on resolving claim-related inquiries, providing accurate insurance information, and delivering excellent customer service with an emphasis on first-call resolution. Key Responsibilities
Handle a high volume of inbound customer service calls in a professional and efficient manner Respond to inquiries related to insurance policies, benefits, coverage, and claims Aim for first-call resolution while maintaining a positive customer experience Assist healthcare providers with claim processing and submission guidance Explain claim adjudication outcomes, reimbursement procedures, and policy details Ensure compliance with Medicare, CMS, and industry regulations Accurately document all customer interactions and claim-related activity Escalate complex or unresolved issues to the appropriate department Collaborate with internal teams to support efficient claims and service operations Required Qualifications
Strong knowledge of Medicare Supplement and other applicable insurance products Bilingual proficiency in English and Spanish required, with the ability to clearly communicate insurance and claims information to diverse audiences. Understanding of healthcare claim adjudication processes Experience in a high-volume inbound call environment Excellent verbal and written communication skills Strong problem-solving skills and attention to detail Ability to work independently and collaboratively within a team Proficiency with customer service systems, databases, and related tools Education
High school diploma or equivalent Skills & Competencies
Customer service excellence Empathy and patience with customers and providers Clear and effective communication Time management and multitasking in a fast-paced environment Attention to accuracy and documentation Adaptability to changing policies, guidelines, and procedures Location: Brookhaven, GA Job Type: Onsite | Direct Hire | Full-Time Pay Details: $45,000.00 to $50,000.00 per year