Insurance Claims Representative
TPIS-Temporary Professional Integrated Services
full-time
Posted on:
Location Type: Hybrid
Location: Caguas • Puerto Rico
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Salary
💰 $14 per hour
Job Level
About the role
- Provide expertise or general claims support by reviewing, researching, processing, and adjusting claims
- Handling different work types like claim adjustment work including Calltraks/Onbase
- Processing different type of Dental claims on CPS Jacada Platform
- Analyze and identify trends and provide reports as necessary
- Consistently meet established productivity, schedule adherence and quality standards
- Authorizes the appropriate payment or refers claims to investigators for further review
- Conducts data entry and claims processing/issues
- Handling issues within turnaround standards
- Ability to handle most claim types / cases / issues that are submitted to the team you are supporting
- Ability handle escalations as needed
- Ability to work multiple functions and applications in a day as needed
- Communicate any changes in trending of inventory, volumes, and quality remediation
- Meet and maintain minimum quality and productivity standards
- Other functions may apply
Requirements
- 1+ years of experience in a production environment
- Proficient in MS Office with solid computer skills (e.g. multiple systems experience, keyboarding skills, Microsoft word, Power Point)
- Proficient in verbal and written English skills
- Willing or able to work 40 hours / week during standard business operating hours Monday - Friday from 7am - 7pm AST (It may be necessary, given the business need, to work occasional overtime on weekends and holidays)
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
claims processingdata entryclaim adjustmenttrend analysisreportingkeyboard skillsMicrosoft WordMicrosoft PowerPointCPS Jacada PlatformCalltraks
Soft Skills
communicationproblem-solvingadaptabilityattention to detailtime managementteam collaborationescalation handlingproductivity focusquality assuranceschedule adherence