Claims Customer Svc Rep/Claims Customer Service Rep in Wixom, MI at Beacon Health Options

Date Posted: 9/4/2019

Job Snapshot

Job Description


We are currently seeking a dynamic Claims Customer Service Representative to join our team at our office in Wixom, MI. The Claims Customer Service Representative will be responsible for answering verbal and written customer/member/provider inquiries including questions regarding benefits, eligibility and certifications. Primary concentration on responding to claims inquiries and resolving problems.

Position Responsibilities:
•Interface with external and internal customers to ensure optimal efficiency of service. Address concerns of dissatisfied and or angry customers/members/providers in a diplomatic manner. Respond to customer inquiries professionally and efficiently. Educate, inform and provide guidance to members/providers/customers/co-workers regarding the claims process.
•Resolve in a timely manner customer/member/provider claims issues through investigation and problem solving. Process related adjustments timely. Follow-up on inquiries as needed, referring problems to other appropriate Beacon Health Options personnel as identified. Keep all parties updated throughout the process.
•Document all inquiries and complaints, including their resolution, appropriately in ServiceConnect. Work all open inquiries daily until resolved.
•Communicate the correct procedure for submitting claims so that the claim can be successfully processed. Explain the payment or denial results accurately as necessary to foster an understanding.
•Contribute to overall success of the claims department in meeting performance guarantees to customers and maintaining customer standards. Ensure that established work processes are followed accordingly.

Position Requirements:

Education: High school diploma or equivalent required. Claims/billing certification from an accredited business institution preferred.

Relevant Work Experience:
• One year experience in Customer Service combined with one year experience in Claims Processing or Claims Research.

Knowledge, Skills & Abilities:
•Must have knowledge and experience using management information systems and software; CAS or other computerized claims processing system, word processing and spreadsheet applications (Microsoft Word and Excel).

Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled

At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email ( Only candidates who have applied for an open position through our Careers page ( will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you


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