Operations Processing Senior Representative

• Performs timely and accurate review of electronic records/documentation scanning for completeness of submissions in accordance with established policies
• Identifies opportunities and reports on inaccuracies that may be present in reviewed documents
• Learns CRM system and is able to access different internal online resources to obtain required information in a timely manner
• Performing inbound and outbound calls to insurance companies, medical facilities and customers in the US
• Responding to customer requests by phone and/or in writing to ensure customer satisfaction and to assure that service standards are met
• Analyzing medical insurance claims for quality assurance
• Resolving moderately routine questions following pre-established guidelines
• Performing routine research on customer inquiries
• Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team

• Proficiency in Microsoft office programs and general computer operations
• Ability to learn and follow basic direction on process
• Must have mastery of the English language, both oral and written
• Must be detail-oriented and organized to maintain accurate records
• Must have the ability to focus and work quickly
• Able to work independently
• Sense of urgency in reporting any concerns to immediate supervisor
• High School diploma or equivalent required
• 1-2 years’ experience working in the medical field preferred

1-2 years’ experience working in the medical field preferred