Randstad Healthcare Customer Service and Claims in Frederick, Maryland

Healthcare Customer Service and Claims

job details:

  • location:Frederick, MD

  • salary:$15 per hour

  • date posted:Friday, February 8, 2019

  • experience:Experienced

  • job type:Temp to Perm

  • reference:S_730123

  • questions:jamee.murray@randstadusa.com678/589-8015

job description

Healthcare Customer Service and Claims

Randstad is seeking the ideal candidate for a contract to hire opportunity with a well known healthcare company.- Please review the details below and apply with your resume.

The ideal candidate must have the ability to navigate through more than one system at a time.- Must have experience in a high production environment and the ability to meet daily, weekly and monthly metrics.- Candidates must be detail oriented, have multi-tasking skills, the ability to learn and retain information quickly. This is not call center, candidates will be making outbound calls to members to review eligibility.


Primary Responsibilities:

  • Provide claims support by reviewing, researching, investigating and resolving all types of claims as well as resolution for health plans, commercial customers, and government entities

  • Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance

  • Perform other duties as assigned

  • Develops and expands knowledge of COB Rules, basic computer skills and business etiquette

  • Performs basic and specialty workflow and administrative tasks with minimal supervision

  • Collaborates with others to identify and solve moderate problems that promote efficiency and quality

  • Initiates telephone calls to members, providers and other insurance companies to gather COB data

  • Receives and respond to incoming telephone inquiries

  • Determines primacy using published COB guidelines

  • Updates eligibility system/ database with outcome of primacy investigation

  • Documents and communicates outcome of investigation following departmental procedures

  • Meets productivity, quality and timeliness goals

Working hours: 8:00 AM - 4:30 PM


Specific Duties:

  1. Make outbound calls to providers to discuss and resolve outstanding overpayments (95% of your day can be on phones)

2 Strive to meet and exceed quality production defined goals (calls/contacts), including a financial target

3.Perform other duties as assigned

4.Strive to meet and exceed quality production defined goals


High School




Required Qualifications:

  • High School Diploma or GED

  • 1+ years of Claims or Call center experience

  • 1+ year of Customer Service experience analyzing and solving customer problem

  • 2+years experience with computer and Windows PC applications, including basic knowledge of Microsoft Excel, Word and Outlook

Preferred Qualifications:

  • 1+ years experience working in the Healthcare Industry

Shift Start/End Time: 8:00 - 4:30 EST

Dress Code: Business Casual

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.