Claims/Customer Service Rep
The Health Plan of West Virginia Inc
Job Description
Job Description
The CDS Rep is responsible for all aspects of processing payment requests for all Consumer Driven Product lines as well as answering customer telephone calls and inquiries in a prompt and professional manner.
Required:
- High School graduate or equivalent.
- Motivated and works independently.
- Detail oriented with good problem solving skills.
- Ability to prioritize and meet deadlines.
- Proficient in basic math skills.
- Proficient in Microsoft Office products.
- Adaptable to changes.
Desired:
- Two (2) years experience in a call center environment.
- Familiar with insurance terminology.
- Knowledge of FSAs, HRAs and/or HSAs.
Requirements:
- Claims and/or calls workload management.
- Proficient use of necessary applications to perform various job functions.
- Establish adequate proficiency in claims and customer service processing systems.
- Meet requirements on annual performance evaluation.
- Consistently displays a positive attitude and acceptable attendance.
- Document calls according to departmental guidelines.
- Strategic in call de-escalation.
- Perform additional assigned tasks and complete them in a timely manner.
Equal Opportunity Employer
The Health Plan is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. The Health Plan strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. The Health Plan employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.
8:00am - 5:00pm40
$50k - $70k
...vital to our daily business operations and customers' success. You grow our agency through... ...proactively marketing relevant products and services. Grow your career as you better your... ...changes and inquiries. Process insurance claims and follow up with clients on claim...ClaimsFor contractorsFlexible hours$15k
A leading claims management company is seeking an Experienced Desk Adjuster to manage claims valued up to $15,000. After training, this remote role involves evaluating insurance claims, conducting thorough investigations, and negotiating settlements. Candidates should...ClaimsHourly payRemote work$40k - $60k
...value-based conversations and remarkable customer experience. If you are a motivated self starter... ...prompt, accurate, and friendly customer service. Service can include responding to... ...eligibility, coverages, policy changes, transfers, claim submissions, and billing clarification....ClaimsHourly payFor contractorsWork at officeMonday to Friday- ...career in a place that celebrates you. About the role Bilingual Customer Service Representatives will be working directly with the customer to... ...activity (including enrollment, third party liability, claims attachments). Having a comprehensive understanding of insurance...ClaimsWork at officeWork from home
$57k - $76k
...people to join our talented team so our service‑oriented, ethical, knowledgeable, and caring... ...may be the place for you. Field Claims Representative – Charleston, WV Our Field... ...environment Provide superior and professional customer service Once eligible, become a certified...Claims$5,000 per month
...0 paid to moving company. Malpractice Insurance Coverage: in a claims made insurance, in an amount of $1,000,000, per claim/$3,000,00... ...Repayment: repay up to $200,000 ($25,000 per year for each year of service commitment). Sign on Bonus: $50,000 (paid when contract signed...ClaimsContract workWork at officeLocal areaRelocation packageWeekend work- ...Job Description Job Description The Claims/Customer Service Rep works with Reinsurance Carriers in filing for reimbursement for groups that have claimants that have gone over the Specific Stop Loss deductible. The Stop Loss Analyst also works with The Health Plan's...ClaimsWork at office
- ...a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Principal Data Scientist Sedgwick is an Equal... ...#LI-TS1 #remote Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating...ClaimsRemote work
$25.25 - $31.25 per hour
...supportive of our unwavering commitment to provide unparalleled service to our clients. Purpose Responsible for the project... ...resolve any issues that may arise as it relates to disputes, or claims Act as liaison between operations and many corporate accounting...ClaimsHourly payFor subcontractorWork at officeRemote work$15k
...Experienced Desk Adjuster – Remote after training Primary Purpose Handles losses and claims valued up to $15,000 for property and casualty insurers through the thorough examination of documents, records, loss reports, and other relevant documentation. Efficiently...ClaimsWork at officeLocal areaRemote work- ...Overview Claims Investigator – Part Time Charleston, WV Uncover the Truth. Protect the Integrity. Advance Your Career. At... ...resolved with accuracy and fairness. Join a global leader in full-service investigations, where integrity meets action, and every day...ClaimsPart timeH1bH2bWork from homeFlexible hoursNight shift
$50k - $55k
...America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Claims Representative, Auto PRIMARY PURPOSE OF THE ROLE: To analyze and process low to mid-level auto and transportation claims....ClaimsContract workWork at officeLocal areaFlexible hours- ...opportunity to develop new accounts and service our existing client base, all while building... ..., back-office support, and highly-rated customer and client support to ensure your success... ...every step of the way—from quote to claim. Company Description Freedom Warranty...ClaimsContract work
$68k - $80k
...Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Claims Adjuster - Workers Comp This role requires direct... ...Adjuster knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. Deliver innovative...ClaimsContract workFlexible hours$23.16 per hour
...Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround... ...to clients and assists with client service programs. Evaluates various claims submitted... ...claim information to TPAs, brokers, or customers utilizing the appropriate application...ClaimsFor contractorsWork at officeLocal area$74.3k - $124.5k
...work to transform the future – for our customers, our communities and our families. You'll... ...dealerships, we provide financing, personalized service and professional expertise to thousands... ...Road Services Company, the insurance claims component of Ford Motor Credit Company,...ClaimsWork at officeImmediate startRelocationFlexible hoursNight shift- ...leader in Independent Medical Examinations (IMEs) and peer review services, trusted by insurance carriers and organizations across the... ...with orthopedic issues Respond to clinical queries to support claims management Deliver detailed IME reports within an expected turnaround...ClaimsExtra incomeContract workFlexible hours
- ...clinical approach, ensuring the right clients find you. Admin Done for You ~ We handle credentialing, billing, claims, EHR, and tech support—so you can focus your time and energy on clinical work. Professional Autonomy ~ Decide...ClaimsLive inWork at officeRemote work
$43k - $56.2k
...Humana Inc is seeking a Claims Research & Resolution Representative 3 to manage claims operations involving customer contact and settlement of claims. You will approve all claim... ...qualifications include 1+ years in customer service, maintaining confidentiality, and a...ClaimsRemote work- ...required. This opportunity provides the ability to customize your schedule and caseload within a standard... ..., and reviews workers' compensation claims by providing an interpretation of the medical appropriateness of services provided by other healthcare professionals in...ClaimsFor contractorsMonday to Friday
- ...Carrington is seeking a Loss Mitigation FHA Claims Specialist to work remotely. The role involves preparing and following up on FHA... ...should have a high school diploma, with preference for mortgage servicing and FHA claims experience. The position offers comprehensive healthcare...ClaimsRemote work
- ...specialty insurance provider is looking for a Workers' Compensation Claims Adjuster for a temporary assignment until May 2026. This role... ...U.S. and involves adjudicating complex claims primarily for customers in MD, PA, and VA. Candidates should have at least two years of...ClaimsTemporary workRemote work
- ...A leading claims management firm is seeking a Claims Examiner for a remote position to analyze workers compensation claims on behalf of clients. Responsibilities include negotiating settlements, processing claims, and communicating with claimants. The ideal candidate...ClaimsRemote workFlexible hours
$110k - $140k
...excellence in both the attorneys and staff it attracts and the services it delivers. We provide all of our employees the tools they need... ...and court appearances; and, interact directly with clients, claim professionals, opposing counsel, colleagues, and staff. Our Firm...ClaimsFull time$3,600 - $8,200 per week
...week) The security deposit and company deposit are fully refundable when you leave the company after 45 days. (if we don't get any claims, accidents) Let me know if you have any more questions, my phone number: (***) ***-**** Max You can do better than you do now!...ClaimsFull timeImmediate start$1,000 - $5,000 per week
...Medical school loan repayment: repay up to $200,000. Sign on bonus: 15% of base salary up to $100,000. Residency stipend: up to $25,000. Bonus Incentives: excellent bonus incentives up to 10% of salary. Both internal and external admissions. Paid claims made insurance.ClaimsLocumRelocation packageMonday to FridayWeekend workAfternoon shift$50.29k
...Resources Associate works closely with the Division of Administrative Services to analyze information and determine appropriate procedures... ...; processing FMLA; overseeing workers’ compensation claims; initiating processing for all leave of absences; utilizing state...Claims- ...Position Overview Are you outgoing and customer-focused? Do you enjoy working with the... ...only State Farm insurance and financial service products. Responsibilities Establish... ...eligibility, coverages, policy changes, transfers, claim submissions, and billing clarification....ClaimsHourly payFor contractors
- ...license in the state requested (Required) Opportunity Highlights Service Provide a meaningful service for the men and women who have... ...medical and psychiatric conditions to support a Veteran's disability claim. As a certified medical disability examiner, you will Review...ClaimsFor contractorsWork at officeFlexible hours
- ...Medical Malpractice Claims Analyst Examine and analyze medical records associated with asserted and potential malpractice claims... ...Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license...ClaimsWork at officeLocal areaShift work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Claims/Customer Service Rep. Be the first to apply!
- remote medical claims processor Charleston, WV
- medical insurance claims specialist Charleston, WV
- airport customer experience specialist Charleston, WV
- customer support representative Charleston, WV
- service person Charleston, WV
- e-commerce customer service representative Charleston, WV
- warehouse customer service representative Charleston, WV
- customer service officer Charleston, WV
- client service representative Charleston, WV
- technical customer service advisor Charleston, WV



