HC & Insurance Operations Senior Rep.

Job Responsibilities:

• Review claim rules and workflows
• Reviews claim requests to determine eligibility for processing and escalate to management on a case to case basis
• Organizing and completing tasks per assigned priorities
• Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team
• Resolving complex situations following pre-established guidelines

Desired Skills & Qualification:

• University degree or equivalent that required 3+ years of formal studies
• Possess excellent typing skill

• Ability to understand logic of standard Payment posting (i.e. Payment, Denials, Adjustments etc.)

• 1+ year(s) of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools.
• Ability to work scheduled shifts from Monday-Friday 07:30 PM to 05:30 AM and to be flexible to accommodate business requirements 
• Ability to communicate (oral/written) effectively in English to exchange information with our client.