Arizona Licensed Healthcare Customer Service Rep

Job Summary

A company is looking for a Healthcare Customer Service Rep II, responsible for handling member service calls related to policy management, benefits, and claims inquiries.

Key Responsibilities

• Process member payments, address billing inquiries, and manage policy terminations and reinstatements
• Provide accurate information about coverage plans and assist with prior authorization and referral processes
• Update member information and assist with claims status updates and inquiries

Required Qualifications

• High School Diploma or GED required
• 2-3 years of experience in claims examination, health insurance, customer service, or a related field
• In-depth knowledge of healthcare terminology, benefits, and policy processes, including ICD-9 and ICD-10 coding
• Must be able to clear a criminal background check
• Strong computer skills for data entry and screen navigation