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Claims Customer Service Representative

Glen Allen, VA

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We are looking for Claims Customer Service Representatives.  This position is with a growing company located in the West End of Richmond.  

Hours: 8-5 or 9-6 Monday-Friday

The position is responsible for taking incoming provider calls for the Claims Customer Service Department.  This position is also responsible for handling all research/adjustment items received in the Claims Customer Service department.

  • Receive and respond to incoming calls in a fast-paced call center environment  
  • Document all incoming provider calls in database
  • Respond to incoming research and adjustment items from the Call Center including faxed requests and reconsiderations
  • Work claims reports and special projects as needed
  • Ability to adjudicate claims in current inventory as needed
  • The ability to work overtime as needed

Job Requirements

  • Minimum 3-5 years’ experience in customer service
  • Minimum 3-5 years claim processing experience
  • Knowledge of IDX/QNXT Claim processing
  • Knowledge of CPT-4, HCPCS coding and ICD-9/ICD10
  • Knowledge of CMS 1500 and UB04 claim forms
  • Knowledge of various types of medical claims ( Primarily Skilled Nursing Facility, Behavioral Health, Personal & Respite Care, Home Health, Hospice DME, and Dialysis claims)
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