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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates strong communication and organizational skills while managing high-volume inbound and outbound calls in a fast-paced environment. Upholds HIPAA regulations and maintains confidentiality while providing exceptional customer service and support.
Highest-signal resume keywords
Customer Service ExperienceClaims Analyst ExperienceHIPAA ComplianceMicrosoft Office ProficiencyOrganizational Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims AnalysisCall Center OperationsProcess ImprovementData LoggingReport Creation
Soft Skills
Verbal CommunicationWritten CommunicationMultitaskingIntegrityProblem-Solving
Tools & Technologies
Microsoft ExcelMicrosoft Outlook
Certifications & Qualifications
Associate DegreeRelevant Certification
Industry Keywords
Managed CareHealth PlanConfidentiality RegulationsPost-Audit Process
About the role
Key responsibilities & impact- Handle inbound provider calls, log details, and resolve issues
- Monitor and respond to internal and external emails within established service levels
- Manage the mailbox, assign emails, monitor aging emails, and create reports for management
- Log and return voicemails within established service levels
- Make outbound calls to assist providers with portal navigation, verify contact details, and confirm receipt of request letters
- Escalate unresolved issues to management and follow up as needed
- Communicate and report workflow or system issues to leadership
- Consistently meet quality and productivity standards
- Uphold HIPAA and confidentiality regulations in all interactions
- Support the post-audit process and company-wide programs through other assigned duties
Requirements
What you’ll need- High School Diploma
- Associate degree or relevant certification is a plus
- Prior customer service or high-volume call center experience required
- 1-year minimum experience working as a Claims Analyst or Claims Auditor in a managed care setting (hospital, health plan or physician office)
- Strong verbal and written communication skills
- Exceptional organizational and multitasking abilities
- Proficiency in Microsoft Office, including Excel and Outlook
- Able to make recommendations to improve and streamline processes
- High level of integrity and confidentiality
- Comfortable working in a high-volume, fast-paced environment with various software programs
- Must uphold HIPAA and confidentiality regulations
Benefits
Comp & perks- Fully remote work
- Professional development and career advancement
- Comprehensive training
- Mentorship program
- Unlimited growth opportunities
- Exposure to world-class healthcare consultants
- Hands-on experience in a dynamic industry
- Flexible remote work
- Best Places to Work organization recognition