HC & Insurance Operations Senior Rep.

Job description

**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.