Description We are offering a contract to hire employment opportunity for a Medical Customer Service Rep in Los Angeles, California. This role is primarily centered around interfacing directly with members of a renowned Health Insurance company and resolving their issues related to medical claims and bills. As a crucial part of our team, you will be expected to use your skills to the best of your ability and contribute positively to our work environment.

Responsibilities:

• Provide excellent customer service by interacting with members over the phone and addressing their claims issues

• Maintain confidentiality and accuracy in all member conversations

• Handle and resolve all questions about Explanation of Benefits (EOBs) or any other queries and concerns related to medical claims

• Conduct investigations on disputed claims, coordinating with internal and external stakeholders as required

• Review medical records/patient bills to confirm, examine, verify and rectify any discrepancies in the claims

• Collaborate closely with medical providers to clarify information or to obtain missing information required for complete claim resolution

• Maintain an in-depth understanding of company policies, procedures, and health plan benefits

• Utilize critical thinking skills to identify alternatives and recommend solutions to deal with billing, claim and eligibility issues

• Regularly follow up with members to update on claim status or to gather additional information as required

• Effectively use CRM, IBM AS/400, Microsoft Excel, Microsoft Office Suites, Microsoft Outlook, and other related tools to perform tasks related to Benefit Functions, Billing Functions, Claim Administration, and Complaint Handling. Requirements

• Proficiency in CRM, IBM AS/400, Microsoft Excel, Microsoft Office Suites, and Microsoft Outlook.

• Familiarity with benefit functions, billing functions, claim administration, and complaint handling.

• Strong customer service skills and ability to interact professionally with patients and healthcare providers.

• Excellent verbal and written communication skills.

• Ability to multitask, prioritize, and manage time efficiently.

• Ability to work in a fast-paced, high-pressure environment.

• Must demonstrate a strong attention to detail and problem-solving skills.

• High school diploma or equivalent is required.

• Ability to uphold the highest level of confidentiality and respect for patient privacy.

• Willingness to learn and adapt to new technologies and procedures.

• Ability to work collaboratively in a team-oriented environment.

Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.

Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app (https://www.roberthalf.com/us/en/mobile-app) and get 1-tap apply, notifications of AI-matched jobs, and much more.

All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.

© 2024 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking “Apply Now,” you’re agreeing to Robert Half’s Terms of Use (https:///www.roberthalf.com/us/en/terms) .