Claims Customer Service Representative

Job Description

LHH is seeking a Customer Service Representative to join a growing team focused on providing exceptional support to policyholders and healthcare providers.

This position is ideal for someone who thrives in a fast-paced environment, enjoys problem-solving, and has experience supporting customers with insurance-related inquiries, claims, and benefits. The successful candidate will play a key role in delivering accurate information, resolving concerns efficiently, and creating a positive customer experience.

What You'll Do

Customer Service

• Handle a high volume of inbound calls from policyholders and providers.
• Provide accurate information regarding insurance policies, benefits, coverage, and claims.
• Resolve customer concerns promptly with a strong focus on first-call resolution.
• Deliver professional, empathetic, and solution-oriented customer service.

Claims Support

• Assist customers and providers with claims-related inquiries and claim status updates.
• Support claim submission processes and clarify reimbursement procedures.
• Educate customers on policy details, benefits, and claims processes.
• Ensure compliance with Medicare and applicable industry guidelines.

Daily Operations

• Maintain accurate records of customer interactions and transactions.
• Collaborate with claims teams and other departments to ensure seamless service delivery.
• Escalate complex issues when necessary while maintaining a positive customer experience.
• Support continuous improvement initiatives and service excellence standards.

Professional Development

• Stay current on Medicare Supplement insurance, healthcare claims processing, CMS regulations, and industry trends.

Qualifications

Experience

• Experience handling high-volume inbound customer calls.
• Knowledge of Medicare Supplement insurance and healthcare claims adjudication processes.
• Strong customer service background with a focus on problem resolution.

Skills

• Exceptional verbal and written communication skills.
• Strong interpersonal and relationship-building abilities.
• Excellent problem-solving and critical-thinking skills.
• High attention to detail and accuracy.
• Ability to multitask and prioritize in a fast-paced environment.
• Experience using customer service software, databases, and CRM systems.
• Ability to work independently and collaboratively within a team environment.

Education

• High school diploma or equivalent required

Ideal Candidate

• Customer-focused and empathetic
• Strong communicator and active listener
• Detail-oriented and organized
• Comfortable in a high-volume call environment
• Knowledgeable in healthcare insurance and claims processes
• Team player with a positive, professional attitude

Job Details:

• Full Time
• In-Office
• Direct Hire

If you're looking for an opportunity to make a meaningful impact while building your career in customer service and insurance operations, we'd love to hear from you!

Equal Opportunity Employer/Veterans/Disabled

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy

The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:

• The California Fair Chance Act
• Los Angeles City Fair Chance Ordinance
• Los Angeles County Fair Chance Ordinance for Employers
• San Francisco Fair Chance Ordinance

Benefit offerings include:

• medical
• dental
• vision
• life insurance
• short-term disability
• additional voluntary benefits
• EAP program
• commuter benefits
• 401K plan

Our program provides employees the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria.

Pay Details: $46,000.00 to $48,000.00 per year

Search managed by:

TroyElan Richardson

Equal Opportunity Employer/Veterans/Disabled

Military connected talent encouraged to apply

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy

The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:

• The California Fair Chance Act
• Los Angeles City Fair Chance Ordinance
• Los Angeles County Fair Chance Ordinance for Employers
• San Francisco Fair Chance Ordinance

Massachusetts Candidates Only: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Skills:

• Adjudication
• Call Volume
• Centers for Medicare and Medicaid Services (CMS)
• Claims Processing
• Communication Skills
• Continuous Improvement
• Customer Experience
• Customer Relations
• Customer Relationship Management (CRM) Systems
• Customer Service Operations
• Customer Service Software
• Customer Support/Service
• Customer Training
• Detail Oriented
• Health Insurance
• Healthcare
• Healthcare Providers
• Industry/Trade Analysis
• Insurance
• Insurance Claims
• Medicare
• Organizational Skills
• Presentation/Verbal Skills
• Problem Solving Skills
• Regulations
• Reimbursement
• Service Delivery
• Team Player
• Track Customer Issues
• Writing Skills

Lee Hecht Harrison