Provider Customer Service Representative (Health Insurance)

• Claims: Status denial rationales appeals medical records research/routing EOB/EOP requests.

• Authorizations & UM: Status denial rationales utilization management appeals prior auth verification.

• Eligibility & Benefits: Status benefit grid interpretation provider participation credentialing.

• Call Handling & Admin: Thorough call documentation resolving next steps educating providers on self-service tools (Availity) and back-to-back call management.

• Pay & Schedule: $16/hour paid training MonFri (8 AM5 PM EST).

• Perks: Medical/dental/vision flexible vacation (post-training) company equipment EAP/wellness with a dedicated trainer employee discounts and 80% internal promotion rate.

Qualifications :

Requirements

• Education & Experience: High School Diploma (or equivalent); 12 years high-volume call center experience.

• Skills: 3540 WPM typing strong written/verbal communication active listening problem-solving and multitasking.

• Workplace & Tech: Dedicated quiet workspace strict schedule adherence and internet speeds of at least 10 Mbps download / 2 Mbps upload.

• Eligibility: Must be a US resident authorized to work in the US.

Preferred Qualifications

• 12 years in a medical office healthcare insurance billing/coding or back-end processing.

Additional Information :

This role is open to those eligible to work in the USA. 

EEOC and Veteran Documentation
During employment employees are treated without regard to race color religion sex national origin age marital or veteran status medical condition or handicap or any other legally protected status.
At times government agencies require periodic reports from employers on the sex ethnicity handicap veteran and other protected status of employees. The purpose of this Administrative EEO Record is for statistical analysis only and is used to comply with government record keeping reporting and other legal requirements. Periodic reports are made to the government on the following information. The completion of the Administrative EEO record is optional. If you choose to volunteer the requested information please note that all 
Administrative EEO Records are kept in a Confidential File and are not part of your Application for Employment or Personnel file.
Please note: YOUR COOPERATION IS VOLUNTARY. INCLUSION OR EXCLUSION OF ANY DATA WILL NOT AFFECT ANY EMPLOYMENT DECISION.

Remote Work :

Yes

Employment Type :

Full-time