Customer Service Representative

Job Summary

We are looking for a Customer Service Representative (CSR) with experience in claims processing and HMO operations to handle member and provider inquiries, resolve claims issues, and ensure high-quality customer support.

Key Responsibilities

• Handle calls related to claims status, denials, and billing issues
• Assist with HMO benefits, eligibility, referrals, and authorizations
• Resolve inquiries and document interactions accurately
• Coordinate with internal teams for issue resolution

Requirements

• 1–3 years of CSR experience in healthcare
• Knowledge of claims processing and HMO workflows
• Strong communication and problem-solving skills