Claims Representative (Health & Dental)

We at Elevance Health are seeking an experienced and highly motivated Claims Representative (Health & Dental) to join our team! As a Claims Representative, you will be responsible for managing customer claims and providing excellent customer service to our members. You will play a critical role in helping us deliver on our commitment to providing outstanding customer service to our members. The ideal candidate should possess excellent customer service, problem-solving, and communication skills. They should have a minimum of 3 years experience in a health and dental claims environment. In addition, the candidate should be familiar with various medical billing systems, possess a thorough knowledge of insurance policies and procedures, and have the ability to make decisions quickly and accurately. If you are looking for a challenging and rewarding opportunity to further develop your claims management skills, then this is the job for you!

Responsibilities:

1. Manage customer claims by evaluating and processing claims according to established company policies.
2. Provide excellent customer service to members by responding to inquiries promptly and accurately.
3. Ensure all claims are completed in a timely and accurate manner.
4. Maintain up-to-date knowledge of insurance policies and procedures.
5. Utilize billing systems and software to process claims efficiently and accurately.
6. Monitor and review claims to ensure accuracy and compliance with all company policies and procedures.
7. Make decisions quickly and accurately to resolve customer inquiries.
8. Identify and investigate potential fraud, waste, and abuse.
9. Identify root causes of customer complaints to ensure customer satisfaction.
10. Analyze and resolve complex customer inquiries.

According to JobzMall, the average salary range for a Claims Representative (Health & Dental) in Asheville, NC, USA is $30,000 to $60,000 annually.

Elevance Health, Inc. is an American health insurance provider. The company's services include medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans through affiliated companies such as Anthem Blue Cross and Blue Shield, Empire BlueCross BlueShield in New York State, Anthem Blue Cross in California,Wellpoint, and Carelon.It is the largest for-profit managed health care company in the Blue Cross Blue Shield Association. As of 2022, the company had 46.8 million members within their affiliated companies' health plans. Prior to June 2022, Elevance Health was named Anthem, Inc.