Description
Job Summary:
We are seeking a motivated and detail-oriented Customer Service Representative to join our team. As a Customer Service Representative, you will be responsible for responding to customer inquiries, reviewing and adjudicating claims and appeals, and ensuring effective customer relations. This position requires strong communication skills, attention to detail, and the ability to handle confidential information with discretion. Join our team and contribute to providing excellent customer service in the healthcare industry.
Job Specifications:
- Job Type: Temp-to-hire
- Company: Kelly® Professional & Industrial
- Location: Columbia, SC
- Pay Rate: $15.00+ per hour
- Shift: between 8:00am - 8pm, Monday-Friday (40 hours per week)
Roles and Responsibilities:
- Respond accurately, timely, and courteously to telephone, written, web, or walk-in inquiries from customers
- Perform research as needed to resolve non-routine inquiries
- Review and adjudicate claims and non-medical appeals following organizational policies and procedures
- Determine whether to return, deny, or pay claims
- Identify incorrectly processed claims and process adjustments and reprocessing actions
- Examine and process claims and non-medical appeals according to business/contract regulations and internal standards
- Enter claims into the claim system after verifying correct coding of procedures and diagnosis codes
- Ensure claims are processing according to established quality and production standards
- Identify and report potential fraud and abuse situations
- Refer complex complaints and inquiries to a lead or manager for resolution
Qualifications & Skills:
- High School Diploma or equivalent required
- 2 years of customer service experience including 1 year of claims or appeals processing OR Bachelor's Degree in lieu of work experience
- Good verbal and written communication skills
- Strong customer service skills
- Good spelling, punctuation, and grammar skills
- Basic business math proficiency
- Ability to handle confidential or sensitive information with discretion
- Proficiency in Microsoft Office
Opportunities:
- Opportunity to contribute to the healthcare industry by ensuring accurate claims processing and customer satisfaction
- Potential for career growth and advancement within the company
- Collaborative work environment with a focus on teamwork and professional development
Company Culture:
At Kelly® Professional & Industrial, we value our employees and believe in providing a supportive and inclusive work environment. We are committed to helping our employees discover their potential and grow in their careers. Join our team and be part of a premiere company that values your skills and contributions.
What happens next:
If your skills and experience align with the requirements of this position, you will proceed to the next steps in the application process. Even if this particular position doesn't work out, your profile will remain in our network, giving you access to a wide range of opportunities.
Helping you discover what's next in your career is our priority. Apply today to be a Customer Service Professional and let's work together towards your professional growth.
As part of our promise to talent, Kelly supports those who work with us through a variety of benefits, perks, and work-related resources. Kelly offers eligible employees voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, a legal plan, and short-term disability. As a Kelly employee, you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to eight paid holidays per benefit year), and a transit spending account. In addition, employees are entitled to earn paid sick leave under the applicable state or local plan. Click here for more information on benefits and perks that may be available to you as a member of the Kelly Talent Community.
Get a complete career fit with Kelly®.
You're looking to keep your career moving onward and upward, and we're here to help you do just that. Our staffing experts connect you with top companies for opportunities where you can learn, grow, and thrive. Jobs that fit your skills and experience, and most importantly, fit right on your path of where you want to go in your career.About Kelly
Work changes everything. And at Kelly, we're obsessed with where it can take you. To us, it's about more than simply accepting your next job opportunity. It's the fuel that powers every next step of your life. It's the ripple effect that changes and improves everything for your family, your community, and the world. Which is why, here at Kelly, we are dedicated to providing you with limitless opportunities to enrich your life—just ask the 300,000 people we employ each year.Kelly Services is proud to be an Equal Employment Opportunity and Affirmative Action employer. We welcome, value, and embrace diversity at all levels and are committed to building a team that is inclusive of a variety of backgrounds, communities, perspectives, and abilities. At Kelly, we believe that the more inclusive we are, the better services we can provide. Requests for accommodation related to our application process can be directed to Kelly's Human Resource Knowledge Center. Kelly complies with the requirements of California's state and local Fair Chance laws. A conviction does not automatically bar individuals from employment.
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