Customer Service/Call Center Representative - Adjudication

We’re thrilled that you are interested in joining us here at the Amynta Group!

Provides exceptional customer service to internal and/or external customers. Responsibilities include but are not limited to: processing claims, providing standard information, completing forms, determining status of claims based on plan guidelines and meeting or exceeding department metrics for call handling, productivity and quality.

ESSENTIAL JOB FUNCTIONS:

Assists consumers by providing highest level of customer service; remains professional and polite at all times.

Responds to standard questions and concerns from customers; follows-up with common questions to document nature and status of claim; communicates in a clear and educated manner.

Processes routine or standard claims and a variety of forms based on documentation and categorization of claims; informs customer of results and closes out claim as appropriate; requests and reviews photos/receipts to complete processi...