Claims Research & Resolution Representative

Employer Industry: Healthcare Insurance Services

• Salary up to $52,300 per year
• Competitive benefits package including medical, dental, vision, and 401(k) retirement savings plan
• Opportunity for professional development and continued education
• Flexible remote work environment
• Supportive and engaging company culture with a focus on employee well-being
• Potential for overtime based on business needs

• Manage inbound calls addressing customer needs related to claims and financial recovery
• Record detailed notes of inquiries, transactions, and actions taken
• Escalate unresolved customer inquiries as necessary
• Interpret department policies to make informed decisions on claims resolution
• Work independently within defined parameters to meet quality standards

• 1 or more years of call center or telephonic customer service experience (within the past 5 years)
• Previous healthcare-related experience or education
• Basic Microsoft Office skills (Word, Excel, Outlook, and Teams)
• Strong technical skills with the ability to navigate multiple software systems
• Ability to maintain confidentiality while working remotely

• Bachelor's Degree
• Prior claims processing experience
• Experience with financial recovery and over payment issues
• Familiarity with Mentor software
• Experience in CRM systems

We prioritize candidate privacy and champion equal‑opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately. We are not the EOR (Employer of Record) for this position.

Our role in this specific opportunity is to connect outstanding candidates with a top‑tier employer.