Job Description
At careerzynith, we're dedicated to delivering exceptional health insurance services to over 1.6 million Ohioans, empowering them to achieve their best possible health and quality of life. As a Claims and Customer Care Specialist, you'll play a vital role in supporting our mission by providing top-notch customer service and processing routine to moderately complex claims. If you're passionate about the healthcare industry and possess excellent communication skills, we encourage you to join our team.
- *About careerzynith**
careerzynith is a leading health insurance provider in Ohio, committed to making a positive impact on the lives of our members. With a strong focus on customer satisfaction and quality service, we strive to create a work environment that fosters growth, innovation, and collaboration. Our team is comprised of dedicated professionals who share a common goal: to deliver exceptional health insurance services that exceed our members' expectations.
- *Responsibilities**
As a Claims and Customer Care Specialist, you'll be responsible for:
- Processing routine claims while providing exceptional customer service via inbound call queues, ensuring timely and accurate resolution of member inquiries.
- Handling inbound calls and written inquiries from members, providers, clients, employers, and brokers, providing clear and concise information on claims and benefits.
- Conducting claims or inquiry-related research under the direction of senior staff, utilizing your analytical skills to resolve complex issues.
- Assisting with projects as directed by management, demonstrating your ability to adapt to changing priorities and deadlines.
- Mentoring and training junior team members in claims processing and customer service, sharing your expertise and knowledge to enhance their skills.
- Conducting complex claims research projects in response to inquiries and escalations, utilizing your problem-solving skills to resolve issues efficiently.
- Providing troubleshooting support for claims issues, ensuring that members receive prompt and effective resolution.
- *Requirements**
To be successful in this role, you'll need:
- An Associate degree in business or healthcare administration, communications, or a related field, or an equivalent combination of training and experience.
- 1-5 years of customer service and/or claims experience, preferably in a call center in the health or dental insurance industry.
- Basic to advanced Microsoft Office skills, depending on the level of the position.
- Knowledge of dental benefits, services, terminology, and American Dental Association coding.
- Understanding of standard customer service best practices and principles.
- Knowledge of the Health Insurance Portability and Accountability Act (HIPAA).
- *Nice-to-Haves**
While not required, the following certifications are highly desirable:
- Certified Dental Billing Specialist (CDBS)
- Certified Dental Coder (CDC)
- Certified Dental Assistant (CDA)
- *Benefits**
As a valued member of our team, you'll enjoy a comprehensive benefits package, including:
- Employee bonus program
- 401(k) with company match up to 4% and additional company contribution
- Health Savings Account with company matching contribution
- Excellent medical, dental, vision, life, and disability insurance
- Access to an Employee Assistance Program for counseling and coaching
- Company holidays and up to 16 PTO days in the first year, with options to carry over unused PTO
- Parental leave for eligible employees after 120 days of service
- Career development programs and classes
- Tuition reimbursement up to $5,250 per year
- *Work Environment and Company Culture**
At careerzynith, we're committed to creating a work environment that's inclusive, supportive, and collaborative. Our team is comprised of dedicated professionals who share a passion for delivering exceptional health insurance services. We offer flexible work arrangements, including remote work options, to ensure that our team members can balance their work and personal life effectively.
- *How to Apply**
If you're passionate about the healthcare industry and possess excellent communication skills, we encourage you to apply for this exciting opportunity. Please submit your resume and a cover letter outlining your experience and qualifications. We can't wait to hear from you!
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