Medical Claims Representative

Job Description

Job Description

Payrate: starting at $20/hr

Duration: 6 month contract to hire

Location: Birmingham, AL (T-Th on site, M and F remote)

Responsibilities:

Insight Global is assisting a client in finding a Claims & Member Services Representative to join a growing healthcare benefits organization located in Birmingham, AL. This individual will serve as a key point of contact for members and healthcare providers, assisting with insurance claims, eligibility questions, benefit inquiries, payment status, and portal support.

This is a fast-paced, customer-focused role that requires strong communication skills, the ability to manage a high volume of calls and emails, and a solid understanding of healthcare insurance and claims processes.

• Handle a high volume of inbound calls, emails, and other correspondence from members and healthcare providers.
• Assist members with benefit inquiries, claims questions, reimbursement requests, and portal-related issues.
• Support providers with claim status requests, payment inquiries, eligibility verification, and benefits information.
• Research and resolve claims-related issues using multiple systems and internal resources.
• Coordinate with internal teams to escalate claims requiring review, reprocessing, or additional analysis.
• Update provider and member information as needed to ensure accurate claim processing and payment delivery.
• Partner with Provider Relations to resolve provider filing and claim submission issues.
• Respond to inquiries professionally and efficiently while maintaining a high level of customer service.
• Document interactions and maintain accurate records within company systems.
• Utilize tools and databases to investigate and resolve complex insurance and claims inquiries.